Have you ever had to file a Form 115Ar? You may be wondering what this is and why you need to file it. A Form 115Ar is an Arkansas state tax form that is used to report the sale or exchange of certain types of property. This form must be filed within thirty days of the sale or exchange, so it's important to understand what qualifies as taxable property. In this blog post, we'll provide an overview of the Form 115Ar and explain why it's necessary to file this form. We'll also provide some tips on how to complete the form correctly. Let's get started!
| Question | Answer |
|---|---|
| Form Name | Form 115Ar |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | SSN, connecticut title 19 form, preparer, 115AR |
Department of Revenue Services
State of Connecticut
PO Box 2990
Hartford CT
(Rev. 4/05)
Form 115AR
Report of Procurement, Continuance, or Renewal
of Insurance With Unauthorized Insurer
Purpose: Use this form to report insurance coverage obtained from an unauthorized insurer. File this report with the Commissioner of Revenue Services within 60 days after the date insurance is procured, continued, or renewed with any unauthorized insurer.
A separate report is required for each new or renewed insurance contract. You must also file Form 115A, Premium Tax Return, and pay a 4% tax on the premium charged for the insurance during the calendar year on or before March 1 of the following calendar year.
Enter your Connecticut Unauthorized Insurance Tax Registration Number, if any:
Name and Address of Insured
First Name and Middle Initial |
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Last Name |
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Address |
Number and Street |
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PO Box |
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City, Town, or Post Office |
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ZIP Code |
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First Name and Middle Initial |
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Last Name |
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Address |
Number and Street |
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PO Box |
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City, Town, or Post Office |
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ZIP Code |
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Name and Address of Insurer
Insurer’s Name |
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Address |
Number and Street |
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PO Box |
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City, Town, or Post Office |
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ZIP Code |
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Insurance Information |
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Contract Number ........................ |
Effective Date ....... |
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Premium Charged ...................... |
Expiration Date |
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General Description of Coverage |
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Subject of the Insurance |
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Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.
Sign
Here
Keep a copy
for your
records.
Signature of Principal Officer |
Date |
Daytime Telephone Number |
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Print Name of Principal Officer |
Title |
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Paid Preparer’s Signature |
Date |
Preparer’s SSN or PTIN |
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Firm’s Name, Address, and ZIP Code |
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FEIN |
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