The form to be used for requesting a premium tax refund shall be provided by the division and shall contain the following information:
- (1) The date of the application;
- (2) The name of the company requesting the refund;
- (3) The address of the company requesting the refund;
- (4) The period of time for which the refund is claimed;
- (5) The amount of the claim;
- (6) The basis for the claim;
- (7) The signature and title of the person entitled to make the claim; and
- (8) An attestation of the signature by a notary public.
Source: 9 SDR 20, effective August 22, 1982; 12 SDR 151, 12 SDR 155, effective July 1, 1986; 39 SDR 219, effective June 26, 2013.
General Authority: SDCL 10-44-1.1.
Law Implemented: SDCL 10-44-2.