Form E-TAX-AGENTS:

NEW AGENCY


Arizona Department of Insurance
100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630


Starting July 1, 2020, we became the
Department of Insurance and Financial Institutions (DIFI).


You must complete this form if the insurer's domicile requires Arizona insurers to pay appointment fees, appointment renewal fees, appointment termination fees, license fees or license renewal fees. Make sure to post the total from this form to Form E-RT.

Priority: 
TAX32000
Form RT: Retaliation Report

For all foreign or alien insurers.  Please refer to information provided in the Arizona Retaliation Guide and in the insurer's Taxes and Fees Data Sheet.

Arizona Retaliation Guide

Use this guide when completing Form E-RT to help identify and calculate the taxes, fees, assessments and other obligations that the insurer's domicile imposes upon Arizona insurers. 

Date Description

Recent Document Updates

3/18/2019 Updated version posted.

 

Form E-RT: Retaliation Report

If the insurer is domiciled in Hawaii, Massachusetts, Minnesota, New York, or Rhode Island, do not complete or file Form E-RT.

For all other foreign/alien insurers, filing complete and correct retaliation reports will allow us serve you efficiently, and with minimal hassle.

Before proceeding with completing the Retaliation Report (Form E-RT):

  • Use the Arizona Retaliation Guide to assist you in identifying taxes, fees and assessments to which Arizona-domiciled insurers are subject in your domicile.
  • Resolve all errors in forms.  Do not submit a form if it contains cells highlighted with a yellow background or red error text.

NOTE:  The Arizona Department of Insurance no longer publishes an Annual Taxes and Fees Data Sheet.

Form Updates

Date Description
1/31/2020 Posted new version