Free Form CT-33 - New York

Staple forms here

CT-33

New York State Department of Taxation and Finance

Life Insurance Corporation Franchise Tax Return
Tax Law -- Article 33
All filers must enter tax period: beginning
File number Business telephone number

Amended return
Employer identification number (EIN)

ending
If you claim an overpayment, mark an X in the box

(
Legal name of corporation

)
Trade name/DBA State or country of incorporation

Mailing name (if different from legal name above)

Date received (for Tax Department use only)

c/o
Number and street or PO box Date of incorporation

City

State

ZIP code

Foreign corporations: date began business in NYS

NAICS business code number (see instructions)

If address above is new, mark an X in the box

Principal business activity

If your name, employer identification number, address, Audit (for Tax Department use only) or owner/officer information has changed, you must file Form DTF95. If only your address has changed, you may file Form DTF96. You can get these forms from our Web site or by fax, or phone. See Need help? in the instructions.

During the tax year did you do business, employ capital, own or lease property, or maintain an office in the Metropolitan Commuter Transportation District? If Yes, you must file Form CT33M (see instructions) ..................... Yes A. Pay amount shown on line 21. Make payable to: New York State Corporation Tax Attach your payment here. Detach all check stubs. (See instructions for details.) B. Federal return filed: (mark an X in one box) Form 1120L Form 1120PC Attach a complete copy of your federal return. Consolidated basis Other:

No

Payment enclosed

A.

Have you been audited by the Internal Revenue Service in the past 5 years? ..................................................... Yes If Yes, list years: Enter primary corporation name and EIN Name
(if a member of an affiliated federal group): EIN

No

Enter parent corporation name and EIN
(if more than 50% owned by another corporation):

Name

EIN

Attach a copy of your complete federal return, a copy of your Annual Report of Premiums and Exhibit of Premiums and Losses (New York) as filed with the New York State Insurance Department, and copies of the following schedules from your Annual Statement: Assets; Liabilities, Surplus and Other Funds; the Summary by Country portion of Schedule D; the Exhibit of Premiums Written, Schedule T; and Reinsurance Assumed, Part 1 of Schedule S.

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Computation of tax and installment payments of estimated tax
1 Allocated entire net income (ENI) from line 82 ................. × .071 ... 2 Allocated business and investment capital from line 58 ..... × .0016 ... 3 Alternative tax (see instructions; attach computation) ............. × .09 ... 4 Minimum tax...................................................................................................................................... 5 Allocated subsidiary capital from line 47 ........................... × .0008 ... 6 Life insurance company premiums from line 86, column A ..... × .007 ... 7 Total tax (amount from line 1, 2, 3, or 4, whichever is greatest, plus lines 5 and 6) .................................... 8 Section 1505(b) floor limitation on tax (enter amount from line 86, column B) .. × .015 ... 9a Tax before EZ and ZEA tax credits (enter amount from line 7 or 8, whichever is greater) ....................... 9b EZ and ZEA tax credits claimed (enter amount from line 100) ............................................................. 9c Tax after EZ and ZEA tax credits (subtract line 9b from line 9a) ......................................................... 10 Section 1505(a)(2) limitation on tax (enter amount from line 88) .... × .02 ... 11 Tax (enter amount from line 9c or line 10, whichever is less) ................................................................... 12 Tax credits (enter amount from line 101) ............................................................................................. 13 Tax due (subtract line 12 from line 11; if less than zero, enter 0) ............................................................. First installment of estimated tax for next period: 14a If you filed a request for extension, enter amount from Form CT5, line 2 ...................................... 14b If you did not file Form CT5 and line 13 is over $1,000, enter 40% (.4) of line 13 ......................... 15 Total (add line 13 and line 14a or 14b) ................................................................................................... 16 Total prepayments from line 99 ....................................................................................................... 17 Balance (if line 16 is less than line 15, subtract line 16 from line 15) ......................................................... 18 Estimated tax penalty (see instructions; mark an X in the box if Form CT-222 is attached) ............. 19 Interest on late payment (see instructions) ........................................................................................ 20 Late filing and late payment penalties (see instructions) ................................................................... 21 Balance due (add lines 17 through 20 and enter here; enter the payment amount on line A) .................... 22 Overpayment (if line 15 is less than line 16, subtract line 15 from line 16) ............................................... 23 Amount of overpayment to be credited to next period .................................................................... 24 Balance of overpayment (subtract line 23 from line 22) ....................................................................... 25 Amount of overpayment to be credited to Form CT33M ............................................................... 26 Refund of overpayment (subtract line 25 from line 24) ........................................................................ 27a Refund of tax credits (see instructions) ............................................................................................. 27b Tax credits to be credited as an overpayment to next year's tax return (see instructions) ................... 28 Issuer's allocation percentage from line 91 .................................................................................... 29 Reinsurance allocation percentage from line 39 ............................................................................ (see instructions; attach separate sheet if necessary)
A Name of ceding company B Reinsurance premiums received C Reinsurance allocation % D Reinsurance premiums allocated to New York State
(column B × column C)

1. 2. 3. 4. 5. 6. 7. 8. 9a. 9b. 9c. 10. 11. 12. 13. 14a. 14b. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27a. 27b. 28. 29.

250 00

% %

Schedule A -- Allocation of reinsurance premiums when location of risks cannot be determined

Totals from attached sheet ....................................... 30 Total (add column D amounts; enter here and include on line 34) .....................................................

30.

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Schedule B -- Computation of allocation percentage (if you do not claim an allocation, enter 100 on line 45; see instructions)
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 New York taxable premiums .............................................................................. 31. New York ocean marine premiums............................................................ 32. New York premiums for annuity contracts and insurance for the elderly ... 33. New York premiums on reinsurance assumed (see instructions) ................ 34. Total New York gross premiums (add lines 31 through 34) ........................... 35. New York premiums ceded that are included on line 35 ........................... 36. Total New York premiums (subtract line 36 from line 35) ............................... 37. Total premiums.......................................................................................... 38. New York premium percentage (divide line 37 by line 38; enter here and on line 29) .................................. Weighted New York premium percentage (multiply line 39 by nine) ........................................................ New York wages, salaries, personal service compensation, and commissions................................................................................... 41. Total wages, salaries, personal service compensation, and commissions................................................................................... 42. New York payroll percentage (divide line 41 by line 42) ........................................................................... Total New York percentages (add lines 40 and 43) ................................................................................. Allocation percentage (divide line 44 by ten; if line 39 or 43 is zero, see instructions) ...................................

39. 40.

% %

43. 44. 45. Schedule C -- Computation and allocation of subsidiary capital (attach separate sheets displaying the information formatted as below if necessary)
A -- Description of subsidiary capital (list the name of each corporation and the EIN here; for each corporation, complete columns B through G on the corresponding
lines below)

% % %

Item A B C D E F G H A Item

Name

EIN

B % of voting stock owned

C Average fair market value

D Average value of current liabilities attributable to subsidiary capital

E Net average fair market value
(column C - column D)

F Issuer's allocation %

G Value allocated to New York State
(column E x column F)

A B C D E F G H

Totals from attached sheet ..... 46 Totals (add amounts
in columns C, D, and E) 46.

47 Allocated subsidiary capital (add column G amounts; enter here and in the first box on line 5) .....................

47.

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Schedule D -- Computation and allocation of business and investment capital
A Beginning of year B End of year C Average fair market value basis

48 Total assets from annual statement (balance sheet) ............................ 49 Fair market value adjustment (attach
computation; if negative amount, use a minus (-) sign) ............................

48.

50 51 52 53 54 55 56

Nonadmitted assets from annual statement Total assets (add lines 48, 49, and 50) Current liabilities ............................ Total capital (subtract line 52 from line 51) ................................................................................... Subsidiary capital from line 46, column E .................................................................................. Business and investment capital (subtract line 54 from line 53) ................................................... Assets, excluding subsidiary assets Beginning of year End of year included on line 54, held as reserves under New York State Insurance Law sections 1303, 1304, and 1305 (use same method to value assets as on line 51) ... 57 Adjusted business and investment capital (subtract line 56 from line 55) .................................... 58 Allocated business and investment capital (multiply line 57 by the allocation percentage from line 45; enter here and in the first box on line 2) .....................................................................

49. 50. 51. 52. 53. 54. 55.

56. 57. 58.

Schedule E -- Computation of adjustment for gains or losses on disposition of property acquired before January 1, 1974
(you may no longer report gain or loss in the same manner you report it on your federal income tax return)
A Description of property
(attach separate sheet if necessary)

B Cost

C Fair market price or value on January 1, 1974

D Value realized on disposition

E New York gain or loss

F Federal gain or loss

Totals from attached sheet 59 Totals (add amounts in columns E and F) .................................................................. 59. 60 New York adjustment (subtract line 59, column F, from line 59, column E; enter here and on line 66; use a minus (-) sign for negative amounts) ................................................................................................... 60. Schedule F -- Officers (appointed or elected) and certain stockholders (include all officers, whether or not receiving any compensation, and all stockholders owning more than 5% of taxpayer's issued capital stock who received any compensation)
A Name and address
(give actual residence; attach separate sheet if necessary)

B Social security number

C Official title

D Salary and all other compensation received from corporation

Totals from attached sheet ..................................................................................................................................... 61 Totals (add column D amounts) ............................................................................................................... 61.

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Schedule G -- Computation and allocation of ENI (see instructions)
62 Federal taxable income before operations loss or net operating loss (NOL) (see instructions) ...... Additions 63 Dividendsreceived deduction (used to compute line 62) ................................................................. 64 Dividend or interest income not included in line 62 (attach list) ..................................................... 65 Interest to stockholders: less 10% or $1,000, whichever is greater ................. 66 Adjustment for gains or losses on disposition of property acquired before January 1, 1974 (from line 60) ............................................................................................................................... 67 Deductions attributable to subsidiary capital (attach list; see instructions) ....................................... 68 New York State franchise tax deducted on federal return (attach list) ............................................ 69a Amount deducted on your federal return as a result of a safe harbor lease ................................. 69b Amount that would have been required to be included on your federal return except for a safe harbor lease ....................................................................................................................... 70 Total amount of federal depreciation from Form CT399 (see instructions) ..................................... IRC section 199 deduction: 71 Other additions (see instructions) ...... 72 Total (add lines 62 through 71) ......................................................................................................... Subtractions 73 Interest, dividends, and capital gains from subsidiary capital (attach list; see instructions) .............. 74 Fifty percent of dividends from nonsubsidiary corporations (attach list; see instructions) ................. 75 Gain on installment sales made before January 1, 1974 (attach list) ............................................. 76 New York operations loss or NOL (attach statement showing computation) ....................................... 77a Amount included on your federal return as a result of a safe harbor lease................................... 77b Amount that could have been deducted on your federal return except for a safe harbor lease .... 78 Total amount of New York depreciation allowed under Article 33 section 1503(b) from Form CT399 (see instructions) .................................................................................................... 79 Other subtractions (attach explanation on separate sheet; see instructions) ......................................... 80 Total subtractions (add lines 73 through 79) ..................................................................................... 81 ENI (subtract line 80 from line 72) ..................................................................................................... 82 Allocated ENI (multiply line 81 by line 45; enter here and in the first box on line 1) .................................. 62. 63. 64. 65. 66. 67. 68. 69a. 69b. 70. 71. 72. 73. 74. 75. 76. 77a. 77b. 78. 79. 80. 81. 82.

Schedule H -- Computation of premiums (see instructions)
A Premiums taxable under section 1510 B Premiums included in tax limitation/floor computation -- section 1505

Life insurance companies 83 Life insurance premiums ...................................................................... 84 Accident and health insurance premiums ............................................ 85 Other insurance premiums (attach list) .................................................. 86 Total (add lines 83, 84, and 85; enter column A total in the first box on line 6 and enter column B total in the first box on line 8) ....................................

83. 84. 85. 86.

87 Insurance corporations who receive more than 95% of their premiums from annuity contracts, ocean marine insurance, and group insurance on the elderly (see instructions) ........................... 88 Total (add lines 86 and 87, column B; enter total here and in the first box on line 10) .................................

87. 88.

Schedule I -- Computation of issuer's allocation percentage
89 New York gross direct premiums ..................................................................................................... 90 Total gross direct premiums ............................................................................................................ 91 Issuer's allocation percentage (divide line 89 by line 90; enter here and on line 28) ............................... 89. 90. 91.

%

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Schedule J -- Composition of prepayments (see instructions)
Date paid Amount Mandatory first installment .......................................................................................... 92. Second installment from Form CT400........................................................................ 93. Third installment from Form CT400 ........................................................................... 94. Fourth installment from Form CT400 ......................................................................... 95. Payment with extension request from Form CT5, line 5 ............................................. 96. Overpayment credited from prior years ............................................................................................ 97. Period Overpayment credited from Form CT33M ............................................. 98. Total prepayments (add lines 92 through 98; enter here and on line 16) ................................................... 99. Summary of tax credits claimed against current year's franchise tax (see instructions for lines 9b, 12, 100, and 101) EZ and ZEA tax credits (attach appropriate form for each credit claimed) 92 93 94 95 96 97 98 99 Form CT601 EZ wage tax credit ............................ Form CT601.1 ZEA wage tax credit ..........................

Form CT602 EZ capital tax credit .......................... 100 Total EZ and ZEA tax credits claimed above; amount cannot reduce the tax to less than the minimum tax (enter here and on line 9b) .................................................................................. Tax credits (attach appropriate form or statement for each credit claimed) Fire insurance premiums tax credit
(enter amount claimed) .........................

100.

Form CT604 QEZE tax reduction credit ................. Form CT606 QEZE credit for real property taxes... Form CT611 Brownfield redevelopment tax credit ... Form CT612, Remediated brownfield credit for real property taxes ................. Form CT613, Environmental remediation insurance credit ............. Form CT631 Security officer training tax credit ...... Form DTF624 Lowincome housing credit ............... Form DTF630 Green building credit ......................... Other credits ..................................... 101. 102.
Designee's phone number ( )

Form CT33R Retaliatory tax credits ....................... Form CT33.1 CAPCO credit ................................... Form CT41, Credit for employment of persons with disabilities ................ Form CT43, Special additional mortgage recording tax credit ........... Form CT44, ITC for financial services industry ............................... Form CT249 Longterm care insurance credit ....... Form CT250 Defibrillator credit .............................. Form CT259, Fuel cell electric generating equipment credit .............

101 Total tax credits claimed above; do not include EZ and ZEA tax credits claimed on line 100 (enter here and on line 12) ... 102 Total tax credits claimed above that are refund eligible (see instructions) .........................................
Designee's name (print) Third ­ party Yes No designee Designee's e-mail address (see instructions)

PIN
Official title Date ID number Address City State Date ZIP code

Certification: I certify that this return and any attachments are to the best of my knowledge and belief true, correct, and complete. Authorized person Paid preparer use only
Signature of authorized person E-mail address of authorized person

Firm's name (or yours if self-employed) Signature of individual preparing this return E-mail address of individual preparing this return

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