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THE STATE OF WYOMING
Insurance Department
106 East 6th Avenue ♦ Cheyenne, Wyoming 82002
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AMENDED QUARTERLY
PREMIUM TAX RETURN
CALENDAR YEAR 2026
OPTins Filing
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NAIC Number:
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Company Name:
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Contact Person:
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Telephone Number:
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E-Mail (Required):
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Pursuant to W.S.§ 26-4-103(k) any insurer authorized to transact business in the state of Wyoming shall pay estimated premium taxes quarterly. Failure to do so shall result in the suspension or revocation of the insurer's certificate of authority.
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Taxes are to be paid on a retaliatory basis. Each quarterly payment shall not be less than 25% of the total premium tax paid during the preceding calendar year.
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Wyoming's tax rates are as follows: Percent
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Life, property, casualty, multiple line=0.7500
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Annuity=1.0000
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Wet marine, transportation
=0.7500
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Prior year credits are not to be taken until notification from the department is received confirming the amount. Please attach a copy of the notification when applying the credit.
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Due dates are: April 30; July 31; October 31. Filing all three quarters at one time is permitted. If filing all three quarters at one time, please fill in each box with the amount due each quarter. Please note the 3 boxes must equal the total remitted amount.
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If filing each quarter separately ONLY put the tax payment amount in the box for the quarter being filed.
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You MUST file a completed form even if your tax liability is zero in any quarter. IF THERE WILL BE NO TAXES DUE FOR THE QUARTERLY PAYMENTS FOR THE ENTIRE CALENDAR YEAR YOU MUST FILE 0.00 FOR ALL THREE QUARTERS AT ONE TIME.
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Quarter 1Quarter 2Quarter 3
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Tax Payment Amount$0.00
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Total Remitted Amount$0.00
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If Amended, Original Amount Paid
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I:\PREMIUM\Premium Tax Forms\2025\2025 Quarterly Updates\Final\WY2025QuarterlyReturnV1
10/20/2025
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WY2025QuarterlyReturnV1
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