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Vermont Annual Statement Filing Instructions for Domestic Special Purpose Financial Captives (SPFCs)

* SPFCs are NOT required to file with the NAIC.

* Note: Only electronic submissions will be accepted. Due Date
DELIVERY INSTRUCTIONS  
Electronic submission to CaptiveMail@state.vt.us  
   
NAIC FINANCIAL STATEMENTS  
Annual Statement (8 ½ " x 14") *Note: Copy of tax return to be included with the annual report filing to the Department. prior to 3/1
Quarterly Statement (8 ½ " x 14")  5/15, 8/15, 11/15
   
NAIC SUPPLEMENTS  
Supplemental Compensation Exhibit prior to 3/1
Risk-Based Capital Report prior to 3/1
Management Discussion & Analysis 4/1
Investment Risk Interrogatories 4/1
   
AUDITED FINANCIAL STATEMENTS  
Audited Financial Statements 6/30
Report of Evaluation of Internal Controls 6/30
Accountant's Letter 6/30
Certification of Review of Audit Workpapers 6/30
   
CERTIFICATION OF LOSS RESERVES AND LOSS EXPENSE RESERVES  
Statement of Actuarial Opinion 6/30
Statement of non-guaranteed elements - NAIC Exhibit 5 Int. #3 6/30
Statement of par/non-par policies - NAIC Exhibit 5 Int. #1.1 6/30
   
OTHER REQUIRED FILINGS  
Material Variances Letter 6/30

Premium tax return and payment mailed to:
Vermont Department of Taxes
Miscellaneous Tax Division
133 State Street
P.O. Box 547
Montpelier,VT 05601-0547
802-828-2551
tax-corpincome@state.vt.us

Premium tax checks payable to:
The Vermont Department of Taxes

*Note: Copy of tax return to be included with the annual report filing to the Department.

2/28
License renewal fees of $500 payable to: Department of Financial Regulation 4/1

 

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