Free 2008 Form 4I - Wisconsin Insurance Company Franchise Tax Return (pdf fillable format) - Wisconsin

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Form

4I

Wisconsin Insurance Company Franchise Tax Return

*C14I08991*
andending
M M D D Y Y Y Y

2008

For2008ortaxableyearbeginning
M M D D Y Y Y Y

Complete form using BLACK INK. DO NOT STAPLE OR BIND
CorporationName NumberandStreet City D Check if applicable and attach explanation: 1 2 Firstreturn-newcorporationorenteringWisconsin Finalreturn-corporationdissolvedorwithdrew 3 4 State

Due Date: 15thdayof3rdmonthfollowingcloseoftaxableyear.
A FederalEmployerIDNumber BBusinessActivity(NAICS)Code ZIP(+4digitsuffixifknown) CStateofIncorporation and Year

Enterabbreviationof stateinbox,orifaforeign country,enterbelow. Shortperiod-changeinaccountingperiod Shortperiod-stockpurchaseorsale

Check if applicable and see instructions: E F G H I Ifthisisanamendedreturn,attachanexplanationofthechanges. Ifyouhaveanextensionoftimetofile,entertheextendedduedate
M M D D Y Y Y Y

IfnobusinesswastransactedinWisconsinduringthetaxableyear,attachacompletecopyofyourfederalreturnandannualstatement. Ifyoufiledafederalconsolidatedreturn,enterParentCompany'sfederalemployerIDnumber . . . . . . . . . . . . . . . . . IfyouhaverelatedentityexpensesandarerequiredtofileScheduleRTwiththisreturn. .

ENTER NEGATIvE NumBERS LIKE THIS ­1000

NOT LIKE THIS (1000) 1 2 3 4 5

NO COmmAS; NO CENTS

1 Federaltaxableincomefromfederalreturn. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Additions(frompage3,Schedule1,line5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Addlines1and2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Subtractions(frompage3,Schedule2,line3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Subtractline4fromline3.Iftheinsurerwriteslifeandnonlifepremiums,checkhere andfillinlines6through9.Otherwise,entertheamountfromline5online9. . . . . . . . . . . . . . 6 Netgainfromoperations,otherthanlifeinsurance. . . . . . 6 7 Totalnetgainfromoperations . . . . . . . . . . . . . . . . . . . . . . 7

.00 .00 .00 .00 .00
%

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8 9

8 Divideline6byline7andmultiplyby100(carryto4placestotherightofthedecimalpoint). . . 9 Multiplyline5byline8.Thisisthetotalincomeotherthanlifeinsuranceincome . . . . . . . . . . .

.

.00
.
%

10 Wisconsinapportionmentpercentagefrompage3,Schedule3,line4(carryto4placestothe rightofthedecimalpoint). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 11 Multiplyline9byline10.ThisisWisconsinincome(loss)beforenetbusinesslossoffset. . . . . 11 . 12 Wisconsinnetbusinesslosscarryforward(attachschedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 13 Subtractline12fromline11.ThisisWisconsinapportionablenetincome. . . . . . . . . . . . . . . . . 13 14 Grosstax(seeinstructions).Ifsubjectto2%maximumtax,checkhere . . . . . . . . . . . . . . 14 15 MultiplytheamountonSchedule2,line2,by7.9%(0.079)andentertheresult . . . . . . . . . . . . 15 16 Addlines14and15.Thisisthetotaltax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 . 17 Nonrefundablecredits(fromScheduleCR,line33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 18 Subtractline17fromline16.Ifline17ismorethanline16,enterzero(0).Thisisnettax . . . . 18 . 19 Recyclingsurcharge(seeinstructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 Endangeredresourcesdonation(decreasesrefundorincreasesamountowed). . . . . 21 Veteranstrustfunddonation(decreasesrefundorincreasesamountowed). . . . . . . . 23 EstimatedtaxpaymentslessrefundfromForm4466W. Ifthisisanamendedreturn,seeinstructions . . . . . . . . . . 23 . 24 Wisconsintaxwithheld. . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 25 Refundablecredits(fromScheduleCR,line37) . . . . . . . . 25 20 21

22 Addlines18through21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

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.00 .00 .00
26

26 Addlines23through25. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IC-020i

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27 Interest,penalty,andlatefeedue(fromForm4U,line17or26). IfyouannualizedincomeonForm4U,checkthespaceafterthearrow..............

27

28 Tax due.Ifthetotaloflines22and27islargerthanline26,enteramountowed. . . . . . . . . . . 28 29 Overpayment.Ifline26islargerthanthetotaloflines22and27,enteramountoverpaid. . . . 29 30 Enteramountofline29youwantcreditedon2009estimatedtax 30

.00 .00 .00 .00 .00

.00

31 Subtractline30fromline29.This is your refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 32 Entertotalcompanygrossreceiptsfromallactivities(seeinstructions). . . . . . . . . . . . . . . . . . . 32 33 Ifthecorporationpaid,accrued,orincurredmorethan$100,000ofexpensestoarelated entity,thecorporationmustfileScheduleRTwiththisreturn.under Wisconsin law, certain related entity expenses may not be allowable unless disclosed on Schedule RT on a timelyfiledreturn.Seeinstructionsfordetails.Online33,entertotalrelatedentity expensesdisclosedonScheduleRT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 34a TotalWisconsinpayroll(seeinstructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34a 34b Totalcompanypayroll(seeinstructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34b

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Additional Information Required
1 Persontocontactconcerningthisreturn: Phone#: Yes No Fax#: Ifyes,attachalistofthenamesandfederalEINs Yes No Yes No Ifyes,attach 2 Cityandstatewherebooksandrecordsarelocatedforauditpurposes: 3 Areyouthesoleownerofanylimitedliabilitycompanies(LLCs)? ofyoursolelyownedLLCs.Didyouincludetheincomesoftheseentitiesinthisreturn?

4 Doyouown,directlyorindirectly,50%ormoreoftheoutstandingvotingstockofanycorporations? Yes Yes No No

alistofthenamesandfederalEINsofthesecorporations.Havetheincomesoftheseaffiliatedcorporationsbeenincludedinthisreturn? 5 Doanycorporations,individuals,partnerships,trusts,orassociationsown50%ormoreofyouroutstandingvotingstock? Ifyes,attachalistofthenamesandfederalEINsoftheseorganizations.Havetheincomesoftheseorganizations Yes No Yes No Ifyes,attacha

beenincludedinthisreturn?

6 Hasyourcorporationbeeninvolvedinanyreorganizationduringtheperiodcoveredbythisreturn? detailedexplanation.

7 Didyoupurchaseanytaxabletangiblepersonalpropertyortaxableservicesforstorage,use,orconsumptioninWisconsin withoutpaymentofastatesalesorusetax? reportusetax. 8 DidanyadjustmentsmadebytheInternalRevenueServicetoyourincomeforprioryearsbecomefinalizedduringthisyear? Yes No Ifyes,seeinstructionsandindicateyearsadjusted: Yes No Ifyes,youoweWisconsinusetax.Seeinstructionsforhowto

Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.
SignatureofOfficer Preparer'sSignature Title Preparer'sFederalEmployerIDNumber Date Date

Youmustfileacopyofyourfederalreturn,relatedschedules,andannualstatementwithyourForm4I.
Makeyourcheckpayabletoandmailyourreturnto: WisconsinDepartmentofRevenue POBox8908 MadisonWI53708-8908

*C24I08991*
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Schedule 1 ­ Additions to Federal Taxable Income 1 Losscarryforwarddeductedinthecalculationoffederaltaxableincome. . . . . . . . . . . . . . . . . 1 2 Dividendincomereceivedtotheextentusedasadeductionindeterminingfederal taxableincome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 AdditionsfromScheduleV,line12. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Additionaldeductionforinsurersrequiredtodiscountunpaidlosses . . . . . . . . . . . . . . . . . . . . 4 5 Total(enteronForm4I,page1,line2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

.00 .00 .00 .00 .00

Schedule 2 ­ Subtractions From Federal Taxable Income 1 SubtractionsfromScheduleW,line16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Incomerealizedfromthepurchaseandsubsequentsaleorredemptionoflotteryprizesifthe winningticketswereoriginallyboughtinWisconsin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Total(enteronForm4I,page1,line4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

.00 .00 .00

Schedule 3 ­ Wisconsin Apportionment Percentage (a) Wisconsin 1 Directpremiumswrittenforinsuranceonpropertyand risks,otherthanlifeinsurance . . . . . . . . . . . . . . . . . . . . . . 1 (b) Total Company

2 Assumedpremiumsfromdomesticinsurance companieswrittenforreinsuranceonpropertyand risks,otherthanlifeinsurance . . . . . . . . . . . . . . . . . . . . . . 2 3 Addlines1and2.Thisisthetotalpremiums. . . . . . . . . . . 3 4 Divideline3,columna,byline3,columnb,andmultiply by100(carry to 4 decimal places). ThisistheWisconsin apportionmentpercentage . . . . . . . . . . . . . . . . . . . . . . . . . 4

.

%

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