Minnesota Fire Safety Surcharge Return

Fire Safety Surcharge Return
2023 IG261, Fire Safety Surcharge Return
*226351*

2023 IG261, Fire Safety Surcharge Return
For the period of (check one):
Jan. 1 – March 31, 2023	
(Due May 15, 2023) 		

April 1 – June 30, 2023	
(Due Aug. 15, 2023)		

July 1 – Sept. 30, 2023	
(Due Nov. 15, 2023)		
Check if: 	

Print or Type

Name of Insurance Company				
Mailing Address		

Check if New Address

Oct. 1 – Dec. 31, 2023
(Due Feb. 15, 2024)

Amended Return 	

No Activity Return

FEIN		

Minnesota Tax ID (required)

NAIC Number	

State/Country of Incorporation

City	

State			

Zip Code		

Contact Person

Email Address	

Website Address		

Daytime Phone 	

Fax Number

Note: Numbers in parentheses refer to line numbers
on NAIC Minnesota state page. Also include all
finance and service charges.

A
Direct Premiums	

B
Dividends	

C
Gross Premiums
(A minus B)

For all policies issued or renewed before July 1, 2023
1	 Homeowners policies (4)  . . . . . . . . . . . . . . . . . . . . . .  1	
	2	 Fire policies (1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2	
	3	 Commercial nonliability policies (5.1)  . . . . . . . . . . .  3	
	4 	 Total (add lines 1 through 3)  . . . . . . . . . . . . . . . . . . .  4	

0.005

	5	 Surcharge rate (0.5%)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5	

Calculate the Surcharge

	6	Surcharge (multiply line 4c by the rate on line 5)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6	
For all policies issued or renewed on or after July 1, 2023
7	 Homeowners policies (4)  . . . . . . . . . . . . . . . . . . . . . .  7	
	8	 Fire policies (1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  8	
	9	 Commercial nonliability policies (5.1)  . . . . . . . . . . .  9	
	10 	 Total (add lines 7 through 9)  . . . . . . . . . . . . . . . . . .  10	

0.0065

	11	 Surcharge rate (0.65%)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11	
	12	Surcharge (multiply line 10c by the rate on line 11)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12	
	13	 Total surcharge (add lines 6 and 12)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13	
	14	Penalty (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14	
	15	Interest (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15	
	16	 TOTAL AMOUNT DUE (or overpaid) (add lines 13 through 15)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16	
		If you owe additional tax (make separate payments for each period):
		Payment method:
Electronic payment
Check (payable to Minnesota Revenue; write MN tax ID number on check; attach Form PV55)
Enter amount paid
Date paid
		(If amount paid is different from amount due on line 9, attach an explanation.)
		If you overpaid: Overpayments will be refunded.

Sign Here

I declare that this return is correct and complete to the best of my knowledge and belief.
Authorized Signature	

Title	

Date	

Daytime Phone

Signature of Preparer	

Print Name of Preparer	

Date	

Daytime Phone

Mail to:
Minnesota Department of Revenue, Mail Station 1780, 600 N. Robert St., St. Paul, MN 55145-1780

I authorize the Minnesota
Department of Revenue
to discuss this tax return
with the preparer.

2023 Form IG261 Instructions

For insurance tax laws, see Minnesota Statutes, Chapter 297I at www.leg.state.mn.us.

Filing Requirements

The fire safety surcharge is effective for insurers licensed to write homeowners, fire and commercial nonliability policy premiums.
This surcharge does not apply to Minnesota township mutual fire insurance companies organized under M.S. 67A.
Mutual property and casualty companies (described in M.S. 297I.05, subd. 3 and 4) shall elect to collect and file the fire safety surcharge
(Form IG261) or the (Form IG262).
The election must be made by Dec. 31 of each year for insurance for policies written or renewed in the succeeding calendar year.
(M.S. 297I.06).

Due Dates

File your quarterly Form IG261 and pay any surcharge due by May 15, Aug. 15 and Nov. 15 of the current year and Feb. 15 of the following
year. Please make separate electronic payments or write separate checks for each return.
The U.S. postmark date, or date recorded or marked by a designated delivery service, is considered the filing date (private postage meter
marks are not valid). When the due date falls on a Saturday, Sunday or legal holiday, returns and payments electronically made or postmarked
the next business day are considered timely. When a return or payment is late, the date it is received at the Department of Revenue is treated
as the date filed or paid.
Extension for filing return. If good cause exists, you may request a filing extension.

Payments

Electronic Payments

If your total insurance taxes and surcharges for the last 12-month period ending June 30 is $10,000 or more, you are required to pay your tax
electronically in all subsequent years.
You must also pay electronically if you’re required to pay any Minnesota business tax electronically, such as sales or withholding tax.
To pay electronically, go to the department’s website at www.revenue.state.mn.us and log in. You’ll need your user name, password and
bank routing and account numbers. When paying electronically, you must use an account not associated with any foreign banks.
If you use other electronic payment methods, such as ACH credit method or Fed Wire, instructions are available on our website or by calling
Business Registration Office at 651-282-5225 or 1-800-657-3605.
Submit separate payments for each return.

Check Payments

If you are not required to pay electronically and you choose to pay by check, you must mail a personalized payment voucher along with your
estimated tax payment to help ensure the payment is credited correctly. Go to www.revenue.state.mn.us and select Make a Payment. Select
Check or Money Order. Use the Payment Voucher System to create a voucher.
When you pay by check, your check authorizes us to make a one-time electronic fund transfer from your account. You will not receive your
canceled check.
Note: If no amount is due or if you pay electronically, do not send in a voucher.

Instructions
Check Boxes

At the top of the form, check if the return is:
•	 an Amended Return: Check only if you are amending a previously filed return for the same period. Include all original and corrected
premiums on the amended return.
•	 a No Activity Return: Check only if you did not write any applicable premiums.

Line Instructions

Premiums must include finance, service and other charges paid to the insurers.

For all policies issued or renewed before July 1, 2023
Line 1

Enter all homeowners multi-peril premiums written (line 4, Minnesota state page).
Continued

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2023 Form IG261 Instructions
Line 2

Enter all fire premiums written (line 1, Minnesota state page).

Line 3

Enter all commercial multi-peril (non-liability) premiums written (line 5.1, Minnesota state page).

For all policies issued or renewed on or after July 1, 2023
Line 7

Enter all homeowners multi-peril premiums written for all policies issued or rewened on or after July 1, 2023 (line 4, Minnesota state page).

Line 8

Enter all fire premiums written for all policies issued or renewed on or after July 1, 2023 (line 1, Minnesota state page).

Line 9

Enter the nonliability portion of all commercial premiums written for all policies issued or renewed on or after July 1, 2023 (line 5.1,
Minnesota state page).

Line 14 — Penalty

Late Payment. If you do not pay the entire surcharge by the due date, a late payment penalty is due. The penalty is 5% of the unpaid
surcharge for any part of the first 30 days the payment is late, and 5% for each additional 30-day period, up to a maximum of 15%.
Late Filing. Add a late filing penalty to the late payment penalty if your return is not filed by the due date. The penalty is 5% of the unpaid
surcharge. When added to the late payment penalty, the maximum combined penalty is 20%.
Payment Method. If you are required to pay electronically and do not, an additional 5% penalty applies to payments not made electronically,
even if a paper check is sent on time.

Line 15 — Interest

You must pay interest on the unpaid surcharge plus penalty from the due date until the total is paid. The interest rate for calendar year 2023 is
5%. The interest rate may change for future years.
To figure how much interest you owe, use the following formula with the appropriate interest rate:

Interest = (surcharge + penalty) x # of days late x interest rate ÷ 365

Mailing Your Return

Mail your return and all required attachments to:
Minnesota Department of Revenue
Mail Station 1780
600 N. Robert St.
St. Paul, MN 55145-1780.
For express deliveries, use our street address:
Minnesota Department of Revenue
600 N. Robert St.
St. Paul, MN 55101

Business Information Changes

Be sure to let us know within 30 days if you change mailing addresses, phone numbers or any other business information. To do so, go to our
website, login to e-Services and update your profile information. By notifying us, we will be able to let you know of any changes in Minnesota
tax laws and filing requirements.

Information and Assistance
Website:	www.revenue.state.mn.us
Email: 	 [email protected]
Phone:	 651-556-3024

This material is available in alternate formats.
For questions about licensing and regulations, contact the Minnesota Department of Commerce:
Website:	www.mn.gov/commerce
Email: 	 [email protected]
Phone:	 651-539-1599 or 1-800-657-3978
Fax:	
651-539-0107
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