The Virginia 801 form is a quarterly tax report specifically designed for surplus lines brokers operating within the Commonwealth of Virginia. This form must be filed by brokers whose annual premiums tax liability is expected to exceed $1,500 and who have received direct gross premium income during the quarter. Timely submission of this report is essential to ensure compliance with state tax regulations.
The Virginia 801 form, officially known as the Surplus Lines Brokers Quarterly Tax Report, serves as a critical tool for surplus lines brokers operating within the Commonwealth of Virginia. This form is mandated for brokers whose annual premiums tax liability is anticipated to exceed $1,500 and who have derived direct gross premium income from policies for insureds based in Virginia during the reporting quarter. It is essential for brokers to understand that if the amount reported on Line 8 is $0, the submission of Form 801 is not required for that specific quarter. The report must be completed accurately, with a signature from the broker or an authorized agency officer, and submitted within 30 calendar days following the end of each quarter. Filing can be accomplished electronically via the Virginia Department of Taxation's eForms platform or through traditional paper methods. In addition to quarterly submissions, brokers are also required to file an annual reconciliation report, Form 802, by March 1 of the following year, regardless of whether any taxes are owed. The form includes several lines that guide brokers in reporting gross premiums, additional premiums, returned premiums, and ultimately calculating the premiums tax owed. A thorough understanding of these components is vital for compliance and to avoid potential penalties, including returned payment fees for any checks that are not honored by the bank.
FORM 801
VIRGINIA SURPLUS LINES BROKERS
QUARTERLY TAX REPORT
GENERAL INFORMATION
The Department’s website, www.tax.virginia.gov, has information to help you with your tax filing responsibilities.
eForms: File and pay your tax online for free. Simply complete the online version of the paper estimated report by entering the tax information as you would if you were completing a paper form.
PDF Forms: Virginia tax forms are available to print or download.
Secure Email: Use our iFile Secure Message Center.
Email Updates: Sign up to receive Virginia tax filing reminders and tax news.
Other Inquiries: Call (804) 404-4163 or write to:
Virginia Department of Taxation
P.O. Box 715
Richmond, VA 23218-0715.
Do not mail returns to this address.
INSTRUCTIONS
Filing Requirements: A surplus lines broker must file this quarterly report, Form 801, if its annual premiums tax liability can reasonably be expected to exceed $1,500 and, during the quarter, it derived direct gross premium income from policies for insureds whose home state is the Commonwealth of Virginia. However, if the amount on Line 8 is $0, Form 801 is not required to be filed for that quarter. Quarterly tax reports must be dated and signed by the surplus lines broker or an agency officer. In addition, the Virginia Surplus Lines Broker’s Annual Reconciliation Tax Report, Form 802, must be filed by March 1 following the close of the taxable year, even if no insurance premiums license tax is owed. Refer to Form 802 for further information.
Where To File and Pay: You can file and pay online with eForms at www.tax.virginia.gov. For paper filing, mail the return to:
P.O. Box 26179
Richmond, VA 23260-6179
The report must be accompanied by a check or money order for the amount due made payable to the Virginia Department of Taxation. Payments returned by the bank will be subject to a returned payment fee of $35 in addition to any other penalties that may be incurred.
When To File and Pay: The report and payment must be postmarked no later than 30 calendar days after the end of each calendar quarter. Payments are considered timely filed if submitted electronically or postmarked on or before midnight of the due date. If the due date falls on a Saturday, Sunday, or legal holiday, the report must be postmarked on the next business day.
LINE INSTRUCTIONS
Line 1 – Gross Premiums: Enter the gross amount of all premiums, assessments, dues, and fees collected, received or derived, or obligations taken during the quarter from policies for insureds whose home state is the Commonwealth of Virginia.
Line 2 – Additional Premiums: Enter the amount of premiums written during the quarter for additional insurance coverage for insureds whose home state is the Commonwealth of Virginia as a result of an insurance rider, rate adjustment, or advance premium less than actual premium.
Line 4 – Returned Premiums: Enter the portion of premiums returned to an insured whose home state is the Commonwealth of Virginia during the quarter as a result of an insurance rider, policy cancellation, rate adjustment, or an excess of advance premium over actual premium.
Line 6 – Premiums Tax: Multiply Line 5 by 2.25%.
Line 7 – Credits from Prior Periods: Enter the portion of premiums returned to an insured whose home state is the Commonwealth of Virginia during the quarter as a result of an insurance rider, policy cancellation, rate adjustment, or an excess of advance premium over actual premium on which tax has already been paid in a prior quarter of this taxable year. If the amount on Line 7 equals or exceeds the amount on Line 6, do not file Form 801. Carry the excess forward to your next quarterly report. Refunds are only issued on the annual return, Form 802.
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Form 801
Virginia Surplus Lines Brokers Quarterly Tax Report
(Doc ID 801)
Office Use
For Period Ending
Due Date
/
Va. Dept. of Taxation 2616010 Rev. 07/20
0000000000000000 8018888 000000
Account Number
Broker License Number
39- ___ ___ ___ ___ ___ ___ ___ ___ ___ F001
Name of Surplus Lines Broker
Address
City, State, and ZIP Code
I declare that this report (including accompanying schedules and statements) has been examined by me and to the best of my knowledge and belief is true, correct, and complete.
Surplus Lines Broker / Agency Officer Signature
Date
Phone Number
1.
Gross Premiums
00
2.
Additional Premiums
3.
Total Premiums (Line 1 plus Line 2). . . .
4.
Returned Premiums
5. Taxable Premiums (Line 3 minus Line 4). . .
5.
6.
Premiums Tax (Multiply Line 5 by 2.25%). .
7.
Credits from Prior Periods
8.
Total Amount Due
(Line 6 minus Line 7)
. 00
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