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Louisiana Department of Insurance Surplus Line Producers Quarterly Tax Statement Form 1265 A

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Louisiana Department of Insurance Surplus Line Producers Quarterly Tax Statement Form 1265 A

What the Louisiana Department of Insurance Surplus Line Producers Quarterly Tax Statement Form 1265 A Is

The Louisiana Department of Insurance Surplus Line Producers Quarterly Tax Statement (Form 1265 A) is the state form surplus line producers use to report surplus line premium receipts and remit applicable premium taxes and fees to the Louisiana Department of Insurance. It aggregates gross surplus line premiums placed during the reporting quarter, calculates the state tax, and documents any adjustments, credits, or prior balances. Producers must complete identifying information, the period covered, tax calculations, and an authorized signature. Accurate quarterly filing ensures compliance with Louisiana surplus lines requirements and supports state tax accounting.

Why Accurate Completion of Form 1265 A Matters

Timely and accurate Form 1265 A filings ensure surplus line premium taxes are remitted correctly, minimize penalties and interest, and maintain producer licensing compliance with the Louisiana Department of Insurance.

Why Accurate Completion of Form 1265 A Matters

Who Typically Prepares and Files Form 1265 A

The form is prepared by licensed surplus line producers or their authorized accounting staff for each reporting quarter.

  • Licensed Surplus Line Producers — Responsible for reporting premiums and remitting taxes for surplus lines placements.
  • Compliance and Finance Teams — Reconcile transaction records, calculate tax due, and maintain supporting documentation for audits.
  • Third-Party Filers and Agents — File on behalf of producers when authorized; must retain evidence of authorization and accurate records.

Step-by-step: Completing Form 1265 A

Follow these sequential steps to complete the quarterly statement accurately and avoid common filing errors.

  • 01
    Gather Records: Collect gross premium reports and policy invoices for the quarter.
  • 02
    Enter Identification: Provide producer license number and legal business name exactly.
  • 03
    Compute Tax: Calculate taxable premium and apply Louisiana surplus line tax rate.
  • 04
    Sign and Submit: Authorize, date, and file the return with remittance or e-file option.

Quarterly reporting schedule and typical due dates

Form 1265 A is submitted quarterly; use the quarter-end dates below to map filing windows and remittance timing.

Quarter 1 (Jan–Mar):

Report for period ending Mar 31; submit by the last day of the following month.

Quarter 2 (Apr–Jun):

Report for period ending Jun 30; submit by the last day of the following month.

Quarter 3 (Jul–Sep):

Report for period ending Sep 30; submit by the last day of the following month.

Quarter 4 (Oct–Dec):

Report for period ending Dec 31; submit by the last day of the following month.

Payment Timing:

Remit tax with the filing unless the DOI allows a separate payment schedule.

Penalties, interest, and compliance risks from incorrect filings

Late filing penalties: Late returns typically incur penalties and interest; state penalties vary and may escalate over time.
Underpayment exposure: Underreporting premiums can trigger assessments, additional tax, and interest charges.
Accuracy penalties: Intentional disregard can lead to severe civil penalties similar to IRS §6721 standards.
License discipline: Repeated noncompliance may affect producer license status or trigger administrative sanctions.
Audit risk: Incomplete records increase the likelihood of DOI audits and extended review periods.
Remittance failures: Failure to remit taxes when due can produce levy actions or collection referrals.

How Form 1265 A compares with other states' quarterly surplus lines returns

A brief comparison of common filing attributes helps producers recognize differences across jurisdictions.

Criteria Form 1265 A Typical Other State Return
Notarization required varies
Electronic filing varies
Signature required
Penalty structure state-determined state-determined

eSignature vendor pricing and capability snapshot for completing Form 1265 A

Compare per-user starting prices and core capabilities for common eSignature vendors; signNow appears first as the initial column for parity comparison.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Varies by plan Varies by plan Varies by plan Varies by plan
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Technical considerations for e-filing and digital signing

Use a platform that supports required file formats, secure signer authentication, and audit trails when submitting Form 1265 A electronically.

  • File Formats: PDF and DOCX supported
  • Integrations: Salesforce, NetSuite, Google Workspace
  • Authentication: Email, SMS code, or advanced methods

Recommended e-filing workflow configuration

Configure your digital workflow to minimize manual entry and preserve an audit-ready record for the DOI and your internal files.

Field Configuration
Upload Document Use a locked PDF template to prevent field changes
Pre-fill Fields Map accounting fields to reduce manual entry
Signer Authentication Enable SMS code or email verification
Notifications Set reminders and delivery receipts for signers

Security and compliance attributes to verify before e-filing

Encryption: TLS 1.2/1.3 in transit, AES-256 at rest
Audit Trail: Complete signer events and metadata
HIPAA Support: BAA available where required
21 CFR Part 11: Compliant options for regulated records
ESIGN / UETA: Meets ESIGN and UETA legal tests
Certifications: SOC 2 Type II and ISO 27001

Best practices to reduce errors and speed processing

Adopt these practices when preparing, signing, and submitting Form 1265 A to reduce rework and audit exposure.

Reconcile before reporting
Reconcile ledger-level premium receipts to the quarterly totals on Form 1265 A prior to filing; this avoids amended returns and supports audit defense.
Use pre-filled templates
Pre-populate producer identification and tax rate fields in a locked template to reduce typos and ensure consistent submissions across quarters.
Preserve supporting documents
Attach policy schedules, invoices, and endorsement records to the filing record so auditors can quickly verify reported premium figures.
Maintain signer authority records
Document authorization for third-party filers and retain executed power-of-attorney or delegation letters to validate signature authority during reviews.

Real-world examples of eSignature and electronic filing in practice

These examples illustrate how organizations streamline signature and filing workflows for recurring compliance documents like Form 1265 A.

Optica Ventures LLC — Brian Fitzgibbons

Optica adopted an electronic signing workflow for recurring compliance forms to reduce turnaround time and paper handling.

  • The team prioritized simplicity and mobile signing.
  • The interface proved simple for internal staff and customers, enabling reliable quarterly filings while preserving an audit-ready trail for regulator reviews.

Martin Properties — Tim Martin

A small broker-dealer moved to electronic signing to process standardized recurring documents faster.

  • Mobile signing handled field environments.
  • By processing documents online with compliant security and audit logs, the team completed recurring tax reporting reliably across distributed staff.

Frequently asked questions about filing Form 1265 A and using eSignatures

Answers to common questions about form validity, corrections, electronic signatures, and DOI submissions to help resolve issues quickly.


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