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New Mexico Free Printable  for 2024 New Mexico Self-Insured Group Tax Annual Return

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Self-Insured Group Tax Annual Return
Form TRD-41399

New Mexico Taxation and Revenue Department TRD-41399 NEW 01/01/2022 Self-Insured Group Tax 20____ Annual Return NAIC NUMBER: STREET/BOX: FEIN, SSN, or ITIN: CITY, STATE, ZIP E-MAIL: CONTACT NAME: PHONE: Check if amended Reason for amending: WHO MUST FILE: The Self-Insured Group Tax pursuant to Section 7-40-3(F) NMSA 1978 is due by any company that has premiums derived from standard premium adjusted by any advance premium discount as defined in the Group-Self Insurance Act (Chapter 52 Article 6). For more information on a self-insured group see the instructions on the next page. The Self-Insured Group Tax pursuant to Section 7-40-7(C) NMSA 1978 must be paid on a quarterly basis. Estimated payments shall be at least one-fourth or 25% of the payment made during the previous calendar year. The final adjustment for payments due for the prior year shall be made with the annual return filed on April 15th.. E-FILE: You must e-file and e-pay Insurance Self Insured (ISI) using the Department’s Taxpayer Access Point (TAP) website at https://tap.state.nm.us. This program has an electronic file (e-file) mandate. If for some reason you are unable to file the return electronically through TAP you are able to request a waiver or exception for e-filing using the Forms RPD-41351, E-File Waiver Request Form and RPD-41350, E-File Exception Request Form. FOR DEPARTMENT USE ONLY Self-Insured Group Tax 1. Direct Written Premiums.......................................................................................................................................................................... 1. 2. New Mexico Premium Tax Rate............................................................................................................................................................... 2. 3. Premium Tax Liability (Multiply line 1 by line 2)........................................................................................................................................ 3. 4. Total Premium Tax Payments Made (Quarter 1-4)................................................................................................................................... 4. 5. Total Premium Tax Due (Subtract line 4 from line 3)................................................................................................................................ 5. 6. Penalty..................................................................................................................................................................................................... 6. 7. Interest..................................................................................................................................................................................................... 7. 8. Total Amount Due . .................................................................................................................................................................................. 8. 0.9% Taxpayer's Signature I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Authorized Signature Title Date Phone Number ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** FINAL DOC Release 01/01/2022 NAME OF INSURER: Final TRD-41399 NEW 01/01/2022 releaseNew 01/01/2022 Mexico Taxation And Revenue Department Self-Insured Group Tax Instructions 20____ Annual Return Quarterly Filing Period Begins Period Ends Due Date 1 January 1st March 31st April 15th 2 April 1st June 30th July 15th 3 July 1st September 30th October 15th 4 October 1st December 31st January 15th WHO MUST FILE The Self-Insured Group Tax pursuant to Section 7-40-3(F) NMSA 1978 is due by any company that has premiums derived from standard premium adjusted by any advance premium discount as defined in the Group-Self Insurance Act (Chapter 52 Article 6). Form: Self-Insured Group Tax - Quarterly Return • TRD-41398\ Pursuant to Section 7-40-2 NMSA 1978, each unauthorized insurer that has assumed a contract or policy of insurance directly or indirectly from an authorized or formerly authorized insurer and is receiving premiums on such policies remaining in force in New Mexico; provided that the ceding insurer does not continue to pay the taxes imposed pursuant to the Insurance Premium Tax Act as to such policy or contract are subject to the Self-Insured Group Tax. NOTE: Instructions for quarterly returns are combined with the form. Please refer to the form listed above for detailed instructions. ANNUAL PREMIUM TAX RETURNS As specified in NMSA 1978, Section 7-40-7(C) The final adjustment for payments due for the prior year shall be made with the annual return filed on April 15, at which time all taxes for that year are due. For a self-insured group, "group" per Section 52-6-2(B) NMSA 1978 means a not-for-profit unincorporated association consisting of two or more public hospital employers or private employers that are engaged in the same or similar type of business, are members of the same bona fide trade or professional association that has been in existence for not less than five years and that enter into agreements to pool their liabilities for workers' compensation benefits; except that public hospital employers shall segregate their accounting records and investment accounts from those of private employers in accordance with applicable state law Form: Self-Insured Group Tax -Annual Return • TRD-41399 Due date: To be accepted as timely filed the Self Insured Group Tax annual report must be submitted online on or before April 15th. This program has an electronic file (e-file) mandate. If for some reason you are unable to file the return electronically through TAP you are able to request a waiver or exception for e-filing using the Forms RPD-41351, E-File Waiver Request Form and RPD-41350, E-File Exception Request Form. PAYMENTS Estimated payments shall be at least one-fourth or 25% of the payment made during the previous calendar year. The final adjustment for payments due for the prior year shall be made with the annual return filed on April 15th. Refer to FYI 401, Special Payment Methods for more information. Make the check or money order payable to New Mexico Taxation and Revenue Department. Mail the payment and all required documentation to Taxation and Revenue Department, P.O. Box 5557, Santa Fe, NM 87502 Email: [email protected]. Certified or overnight mailing address: Attn-Insurance Premium Tax, 1200 S. St. Francis Drive, Santa Fe, New Mexico 87504. Important: Balances and Credits have been removed from all returns. Any overpayments will require RPD-41071, Application for Refund, to be submitted to the department along with supporting documents and an Amended Return if applicable. COMPLETED RETURNS All fields in the form must be completed. No field should be left blank. For numeric fields requiring a balance, mark the field as zero if there no activity or balance related to that field. NOTE: When you provide a check as payment, you authorize us to use information from your check to make a onetime electronic fund transfer from your account. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day you make your payment. For forms to be considered complete, they must be signed, with the Title and Date entered by Authorized Representative. QUARTERLY PREMIUM TAX RETURNS The Self-Insured Group Tax pursuant to Section 7-40-7(C) NMSA 1978 must be paid on a quarterly basis. The Self--Insured Group Tax estimated payments and returns are due on April 15, July 15, October 15, and January 15. Estimated payments shall be at least one-fourth or 25% of the payment made during the previous calendar year. The final adjustment for payments due for the prior year shall be made with the annual return filed on April 15th. LINE INSTRUCTIONS Line 1. Direct Written Premiums. This is the amount of net premiums received or written by a self-insured group within the state during the calendar year. Line 2. New Mexico Premium Tax Rate. A rate of nine-tenths percent (0.9%). 1 ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** NEW LEGISLATION Effective July 1, 2021 under new legislation moved the Self Insured Group Tax to the Insurance Premium Tax Act. This legislation transferred the duty to collect this specific Insurance Premium Tax to the Taxation and Revenue Department. Final TRD-41399 NEW 01/01/2022 releaseNew 01/01/2022 Mexico Taxation And Revenue Department Self-Insured Group Tax Instructions 20____ Annual Return Line 7. Interest. Interest accrues daily on the unpaid principal of tax due, and it can change on a quarterly basis. You can find the effective annual and daily interest rates on the Department's web page at www.tax.newmexico.gov or by contacting the Department. Line 4. Total Premium Tax Payments Made. Enter the amount of the estimated self-insured group tax payments made for quarters 1 through 4. Line 8. Total Amount Due. Enter the total of Lines 5, 6, and 7. Pay this amount. Line 5. Total Premium Tax Due. Subtract Line 4 from Line 3. Line 6. Penalty. Add penalty if the entity fails to file timely or to pay the amount on Line 5 when due. Calculate the penalty by multiplying the amount on Line 5 by 2%, then by the number of months or partial months for which the return or payment is late, not to exceed 20% of the tax due. Penalty for failure to file or pay on time may not be less than $5.00. Taxpayer's Signature. This return needs to be signed by the authorized and include the date and title of that individual along with a phone number where they can be reached. 2 ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** Line 3. Premium Tax Liability. Multiply Line 1 by Line 2.
Extracted from PDF file 2023-new-mexico-form-trd-41399.pdf, last modified December 2021

More about the New Mexico Form TRD-41399 Individual Income Tax TY 2023

The Self-Insured Group Tax is filed by companies who have premiums obtained from standard premium and are adjusted by any advance discounts on those premiums

We last updated the Self-Insured Group Tax Annual Return in February 2024, so this is the latest version of Form TRD-41399, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form TRD-41399 directly from TaxFormFinder. You can print other New Mexico tax forms here.


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Other New Mexico Individual Income Tax Forms:

TaxFormFinder has an additional 80 New Mexico income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form PIT-ES Estimated Payment Voucher
Form PIT-1 Personal Income Tax Return
Form PIT-RC Rebate & Credit Schedule
Form PIT-ADJ Schedule of Additions & Deductions and Exemptions
Income Tax Instructions Individual Income Tax Instructions

Download all NM tax forms View all 81 New Mexico Income Tax Forms


Form Sources:

New Mexico usually releases forms for the current tax year between January and April. We last updated New Mexico Form TRD-41399 from the Taxation and Revenue Department in February 2024.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of New Mexico Form TRD-41399

We have a total of two past-year versions of Form TRD-41399 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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