Get the free 2017 Form Specifications - Rhode Island Division of Taxation - RI.gov
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1 2 Returned Premiums. 2 3 Net Taxable Premium. Subtract line 2 from line 1. 4 SURPLUS LINE BROKER TAX. First name License number SSN Last MI Broker 1 SSN/FEIN Signature of broker Page 2 For policies invoiced from January 1 2017 through December 31 2017 Company carrying the risk not the Wholesale Broker Name of Insured Risk Location Invoice Premium Return Carrier NAIC Premium totals - - - Page 3 Additional. Subtract line 10 from line 9. This is the amount to be refunded. Mail Form T-71A by...
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