All Tax Forms and Instructions
| Insurance companies can now file their tax reports and tax payments electronically, using the new "OPTins" system available from the NAIC. Click here for details. |
| If you need a form or assistance, please call: (602) 364-3246 for surplus lines tax (602) 364-2713 for insurer taxes and fees |
| Click on a Company or Taxpayer Type (left menu) to go the location of the applicable forms. |
| Warning! Do not attempt to use a version of Adobe Acrobt older than version 8 for the fillable forms posted on this webpage. Click here to download the latest free Adobe Acrobat Reader. | ||
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| FILLABLE FORM INSTRUCTIONS | ||
| CLICK ON YOUR COMPANY TYPE FOR ARIZONA FORMS, DUE DATES AND INSTRUCTIONS. You must file forms by the due dates stated in the form. To confirm your company type or to obtain other information about the company, click the 'License Search' tab at the top of this web page. For further assistance, call (602) 364-3999 and provide your NAIC number or Arizona company number. | ||
| Forms Included | Form Type | Form Name | ||
| ACCREDITED REINSURER (FOREIGN OR ALIEN) | ||||
| E-ANNUALFEES | FILLABLE | ANNUAL FEES REPORT | ||
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| AHCCCS CONTRACTOR | ||||
| E-QTR | FILLABLE | QUARTERLY PREMIUM TAX REPORT | ||
| E-QTR.INSTRUCTION | QUARTERLY PREMIUM TAX REPORT INSTRUCTIONS | |||
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| EMPLOYEE BENEFIT TRUST OR VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION | ||||
| FORM IS MAILED | ||||
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| FRATERNAL BENEFIT SOCIETY | ||||
| E-FRATERNAL | FILLABLE | ANNUAL TAX AND FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
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| HEALTH CARE SERVICES ORGANIZATION | ||||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-HEALTHORG | FILLABLE | HEALTH ORGANIZATION ANNUAL TAX AND FEES REPORT | ||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-AHP | MS EXCEL FILE | ACCOUNTABLE HEALTH PLAN SMALL GROUP PREMIUMS | ||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
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| HOSPITAL, MEDICAL, DENTAL AND OPTOMETRIC SERVICE CORPORATION | ||||
| E-ANNUALTAX.INSTRUCTION | FILLABLE | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | ||
| E-HEALTHORG | FILLABLE | HEALTH ORGANIZATION ANNUAL TAX AND FEES REPORT | ||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-HEALTHORG.HDMO | MS EXCEL FILE | HEALTH ORGANIZATION ANNUAL TAX EXEMPTIONS | ||
| E-AHP | MS EXCEL FILE | ACCOUNTABLE HEALTH PLAN SMALL GROUP PREMIUMS | ||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
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| INDUSTRIAL INSURED | ||||
| E-INDINS.ALLOCATION | FILLABLE | CERTIFIED STATEMENT OF RISK PERCENTAGE ALLOCATIONS | ||
| E-INDINS.CERTIFICATION | FILLABLE | INDUSTRIAL INSURED CERTIFICATION STATEMENT | ||
| E-INDINS.INSTRUCTION | INDUSTRIAL INSURED FILING INSTRUCTIONS | |||
| E-INDINS.TAX | FILLABLE | PREMIUM RECEIPTS TAX RETURN | ||
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| LIFE AND/OR DISABILITY INSURER | ||||
| E-LD | FILLABLE | ANNUAL TAX AND FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-AZAGENTS | MS EXCEL FILE | ARIZONA AGENTS LIST - FOR RETALIATORY TAX AND FEES WORKSHEET | ||
| E-AHP | MS EXCEL FILE | ACCOUNTABLE HEALTH PLAN SMALL GROUP PREMIUMS | ||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
| E-SURVEY | FILLABLE | SURVEY OF ARIZONA DOMESTIC INSURERS | ||
| E-SURVEY.INSTRUCTIONS | SURVEY OF ARIZONA DOMESTIC INSURERS INSTRUCTIONS | |||
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| LIFE AND/OR DISABILITY REINSURER (ARIZONA DOMESTIC) | ||||
| E-ANNUALFEES | FILLABLE | ANNUAL FEES REPORT | ||
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| LIFE CARE PROVIDER | ||||
| Annual Statement Forms And Quarterly Filing Requirements | ||||
| MECHANICAL REIMBURSEMENT REINSURER (ARIZONA DOMESTIC) | ||||
| E-ANNUALFEES | FILLABLE | ANNUAL FEES REPORT | ||
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| MORTGAGE GUARANTY INSURER (ONLY) | ||||
| E-PC | FILLABLE | ANNUAL TAX AND FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-AZAGENTS | MS EXCEL FILE | ARIZONA AGENTS LIST - FOR RETALIATORY TAX AND FEES WORKSHEET | ||
| E-SURVEY | FILLABLE | ARIZONA DOMESTICS ONLY | ||
| E-SURVEY.INSTRUCTIONS | SURVEY INSTRUCTIONS | |||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
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| PREPAID DENTAL PLAN ORGANIZATION | ||||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-HEALTHORG | FILLABLE | HEALTH ORGANIZATION ANNUAL TAX AND FEES REPORT | ||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
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| PREPAID LEGAL INSURER (ONLY) | ||||
| E-PC | FILLABLE | ANNUAL TAX AND FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-AZAGENTS | MS EXCEL FILE | ARIZONA AGENTS LIST - FOR RETALIATORY TAX AND FEES WORKSHEET | ||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
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| PROPERTY AND/OR CASUALTY INSURER | ||||
| E-PC | FILLABLE | ANNUAL TAX AND FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-AZAGENTS | MS EXCEL FILE | ARIZONA AGENTS LIST - FOR RETALIATORY TAX AND FEES WORKSHEET | ||
| E-SURVEY | FILLABLE | SURVEY OF ARIZONA DOMESTIC INSURERS | ||
| E-SURVEY.INSTRUCTIONS | SURVEY OF ARIZONA DOMESTIC INSURERS INSTRUCTIONS | |||
| E-ZONE | Please call (602) 364-3997 for forms | |||
| M-ZONE | Please call (602) 364-3997 for forms | |||
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| QUALIFIED REINSURER TRUST ARS § 20-261.01(A)(4) OR QUALIFIED REINSURER BASED ON SURPLUS ARS § 20-261.01(A)(3) AND (6) | ||||
| E-ANNUALFEES | FILLABLE | ANNUAL FEES REPORT | ||
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| RISK RETENTION GROUP (FOREIGN) | ||||
| E-RG | FILLABLE | ANNUAL TAX AND FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-INSTALLMENT TAX | FILLABLE | INSTALLMENT TAX REPORT | ||
| E-AZAGENTS | MS EXCEL FILE | ARIZONA AGENTS LIST | ||
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| SURPLUS LINES BROKER WITH ARIZONA LICENSE | ||||
ALL SURPLUS LINES TAX FORMS ARE ON THE SURPLUS LINES ASSOCIATION OF ARIZONA WEB SITE AT www.sla-az.org - Please call 602 364-3246 for assistance. |
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| SURPLUS LINES BROKER NONRESIDENT WITHOUT ARIZONA SURPLUS LINES LICENSE | ||||
ALL SURPLUS LINES TAX FORMS ARE ON THE SURPLUS LINES ASSOCIATION OF ARIZONA WEB SITE AT www.sla-az.org - Please call 602 364-3246 for assistance. |
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| TITLE INSURER (ARIZONA DOMESTIC) | ||||
| E-ANNUALFEES | FILLABLE | ANNUAL FEES REPORT | ||
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| TITLE INSURER (FOREIGN) | ||||
| E-ANNUALFEES | FILLABLE | ANNUAL FEES REPORT | ||
| E-ANNUALTAX.INSTRUCTION | ANNUAL PREMIUM TAX AND FEES INSTRUCTIONS | |||
| E-TITLE.RETALIATORY | FILLABLE | FOREIGN TITLE INSURER RETALIATORY REPORT | ||
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| UNAFFILIATED CREDIT LIFE AND/OR DISABILITY REINSURER (ARIZONA DOMESTIC) | ||||
| Forms will be avaliable in June | ||||
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