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Get MN DoR IG260 2018

Nd complete to the best of my knowledge and belief. Signature of Broker Signature of Preparer Print Name of Preparer Date Daytime Phone Date Daytime Phone Mail to: Minnesota Revenue, Mail Station 1780, St. Paul, MN 55145-1780 (Rev. 11/17) I authorize the Minnesota Department of Revenue to discuss this tax return with the preparer. IG260 page 2 2018 Nonadmitted Insurance Premium Tax Return for Surplus Lines Brokers (continued) A NAIC Number B C Name of Insurer Policy.

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