Hawaii Tax Form G45

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FORM G-45
WEB
STATE OF HAWAII
—
DEPARTMENT OF TAXATION
(Rev. 2008)
FILL
GENERAL EXCISE/USE
I 1 1 1 1 1 1 1 I I ~ l I 1 1 1 1 1 1 1 1 I I U II I I ~ HI ~ f ~
TAX
RETU RN
GBFO81
~
~
Month
Quarter
X
Semiannual
PERIOD ENDING (MM/YY)
06
14
NAME: HAWAII CAPTIVE INSURANCE COtJNC
HAWAIITAXI.D.NO.W 32184984
-
01
Last4digitsofyourFElNorSSN
2660
Column a
Column
b
Column c
BUSINESS
VALUES, GROSS PROCEEDS
EXEMPTIONS/DEDUCTIONS
TAXABLE INCOME
ACTIVITIES
OR GROSS INCOME
(Attach Schedule GE)
(Column a minus Column b)
PART I
-
GENERAL EXCISE and USE TAXES
@1/2
OF 1% (.005)
1. Wholesaling
LU
2. Manufacturing
3. Producing
Ix
0
>-
4. Wholesale Services
LU
5. UseTaxon
~
Imports For Resale
Ix
O
6. Business Activities of
Disabled Persons
LU
7.
Sum of Part I, Column c (Taxable Income)
—
Enter the result here and on Page 2, line 21, Column (a)
~ PART II
-
GENERAL EXCISE and USE TAXES @4% (.04)
•
8. Retailing
9. Services Including
Professional
10. Contracting
11. Theater, Amusement
and Broadcasting
12. Commissions
13. Transient
Accommodations F~entals
14. Other Rentals
15. Interest and
All Others
0
0
16. Use Tax on Imports
For Consumption
17. Sum of Part II, Column c (Taxable Income)
—
Enter the result here and on Page 2, line 22, Column (a)
0
DECLARATION
-
I declare, under the penalties set forth in section 231-36, HRS, that this return (including any accompanying schedules or statements) has been
examined by me and, to the best of my knowledge and belief, is a true, correct, and complete return, made
in
good faith for the tax period stated, pursuant to the
General Excise and Use Tax Laws, and the rules issued thereunder.
ID No 9 9
IN
THE CA5E OF A CORPORATION OR PARTNERSHIP,
THIS
RETURN
MUST
BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT.
~
~rs*Tr~c*Suir-cr
j~~’
Thi4•ij.
-:
‘Continued on Page 2
—
Parts V & VI MUST’ be completed
~
10
I

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