Wis. Admin. Code Office of the Commissioner of Insurance, ch. Ins 6, app 2
Year Ending December 31, 2
This report is to be filed with the Commissioner of Insurance, State of Wisconsin, Madison, Wisconsin 53702, on or before March 1, 2_____
Agent | Business address, including zip code | Date | ||||
Proposal No. and Date* (1) | Name of Insured (2) | Name of Insurance Company (3) | Contract Number (4) | Term and Effective Date (5) | Premium Charged (6) | 3%** Premium Tax Collected (7) |
*Proposals are to be numbered consecutively | . Premium Collected During Year ......................... | $____________ | ||||
** 1/2 of 1% for Ocean Marine Insurance | Tax Due @ 3%**-Total Column (7) ..................... | $ _____________ | ||||
Amount Enclosed ................ | $ ______________ | |||||
Wis. Admin. Code Office of the Commissioner of Insurance, ch. Ins 6, app 2
2011 Wisconsin Act 224 changed the tax rate for surplus lines insurance which is ocean marine insurance to the same 3% rate for all other surplus lines insurance. Any previous reference to a 1/2 of 1% rate for ocean marine insurance in this rule is not enforceable as that insurance is now taxed at the same 3% rate for all surplus lines insurance.