Hawaii Tax Form G45 (Page 2 of 4) in pdf

WEB

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FORM G-45

Page 2 of 2

FILL

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Name:

HAWAII CAPTIVE INSURANCE COUNC

HawaiiTaxl.D.No.W 32184984

Period Ending 06

Last 4 digits of your FEIN or SSN 2660

______

GBFO 82

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 III

INSURANCE COMMISSIONS

.15% (.0015)

18. Insurance

Commissions

___________________________________________________

Enter this amount on line 23, Column (a)

PART IV

CITY & COUNTY OF HONOLULU SURCHARGE TAX

@1/2

(.005)

19. Oahu Surcharge

Enter this amount on line 24, Column (a)

PART V

—

SCHEDULE OF ASSIGNMENT OF TAXES BY DISTRICT

(ALL taxpayers MUST complete this Part and may

be subject to a 10% penalty for noncompliance.) See Instructions.

Place an X

in the box of the taxation district in which

you have Conducted business. IF you did business in MORE THAN ONE district, place an X in the box for “MULTI” and

attach Form G-75.

20.

Oahu

Maui

Hawaii

Kauai

MULTI

PART VI -TOTAL PERIODIC RETURN

TAXABLE INCOME

TAX RATE

TOTALTAX

Column (a)

Column (b)

Column (c)

Column (a) X Column (bI

21.

Enter the amount from Part I, line 7

.00

x .005

______________________

22.

Enter the amount from Part II, line 17

.00

.04

23.

Enter the amount from Part Ill line 18, Column c

.00

x .0015

______________________

24.

Enter the amount from Part IV, line 19, Column c

.00

x .005

_____________________

25.

TOTAL TAXES DUE.

Add column (c) of lines 21 through 24 and enter result here. If you

did not have any activity for the period, enter “0.00” here

25.

PENALTY

$__________________

26. Amounts Assessed During the Period

(For Amended Return ONLY)

INTEREST

$___________________

__________________________

27.

TOTAL AMOUNT.

Add lines 25 and 26

27.

28. TOTAL PAYMENTS MADE FOR THE PERIOD (For Amended Return ONLY)

28.

29. CREDITTO BE REFUNDED. Line 28 minus line 27 (For Amended Return ONLY)

29.

30. ADDITIONAL TAXES DUE. Line 27 minus line 28 (ForAmended Return ONLY)

30.

31.

FOR LATE FILING ONLY

fl~7~EST

$___________

31.

______________

32. TOTAL AMOUNT DUE AND PAYABLE (Original Returns, add lines 27 and 31;

Amended Returns, add lines 30 and 31)

32.

33. PLEASE ENTER THE

AMOU NT OF YOUR

PAYMENT.

Attach a check or money order payable

to “HAWAII STATE TAX COLLECTOR” in U.S. dollars to Form G-45. Write “GE”, the filing period, and your HawaiiTax

ID. No. on your check or money order. Mail to: HAWAII DEPARTMENT OF TAXATION, R 0. BOX 1425,

HONOLULU, HI 96806-1425 or file and pay electronically at

If you are NOT submitting a payment with this return, please enter “0.00” here

33.

34.

GRAND TOTAL OF EXEMPTIONSIDEDUCTIONS CLAIMED.

(Attach Schedule GE) If Schedule GE is not attached, exemptions/deductions

claimed will be disallowed

34.

ID No

~0~)

220W1 0-12

Hawaii Tax Form G45 Page 2

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