Form 480.40f - Foreign Life Insurance Company Income Tax Return

ADVERTISEMENT

Form 480.40F Rev. 09.99
Reviewer:
Liquidator:
Serial Number
_____
COMMONWEALTH OF PUERTO RICO
_____
DEPARTMENT OF THE TREASURY
Year
Year
Field audited by:
Foreign Life Insurance Company
AMENDED RETURN
Income Tax Return
Date ___/ ___/ ___
Payment Stamp
R
M
N
TAXABLE YEAR BEGINNING ON
_________
__
__________
___
, __
AND ENDING ON
, __
Employer's Identification Number
Taxpayer's Name
Postal Address
Department of State Registry No.
Industrial Code
Municipal Code
Zip Code
Location of Principal Industry or Business - Number, Street, City
Telephone Number - Extension
Date Incorporated
Check the corresponding box, if applicable
Change of Address
FOR COLLECTOR'S USE ONLY
>
First return
>
Last return
Day___/ Month____/ Year____
>
>
Receipt Control Number
Yes
No
Place Incorporated
Contracts with Governmental Entities
_________________________
No.
>
>
Yes
No
____________________
Amount:
Part I
Net Income
1. Life insurance company taxable income (As reported on attached certified copy of income tax return
filed with the U.S. Commissioner of lnternal Revenue or foreign country).....................................................................
0 0
(1)
2. Puerto Rico gross direct business (As reported on Schedule T in the Annual Statement required under
Section 3.310 of the Puerto Rico Insurance Code):
0 0
a) Puerto Rico gross direct life insurance premiums .........................................................
(2a)
0 0
b) Puerto Rico gross direct annuity considerations ...........................................................
(2b)
0 0
c) Puerto Rico gross direct accident and health insurance premiums ...............................
(2c)
0 0
d) Puerto Rico gross direct annuity and other fund deposits .................................................
(2d)
3. Total Puerto Rico gross direct business (Add lines 2(a) through 2(d)) ...........................................................................
0 0
(3)
4. Total direct business (As reported on Schedule T in the Annual Statement required under Section 3.310
of the Puerto Rico Insurance Code):
0 0
a) Total direct business on life insurance premiums .........................................................
(4a)
0 0
b) Total direct business on annuity considerations ............................................................
(4b)
0 0
c) Total direct business on accident and health insurance premiums ..............................
(4c)
0 0
d) Total direct business on annuity and other fund deposits .................................................
(4d)
5. Total direct business (Add lines 4(a) through 4(d)) ..............................................................................................................
0 0
(5)
6. Allocation factor (Divide line 3 by line 5) ....................................................................................................................
(6)
7. Net income subject to normal tax (Multiply line 1 by line 6) ..............................................................................................
0 0
(7)
8. Less: Surtax net income credit (See instructions) ................................................................................................................
0 0
(8)
9. Net income subject to surtax (Subtract line 8 from line 7) ...............................................................................................
0 0
(9)
Part II
Computation of Tax
10.
Normal tax (Multiply line 7 by 20%) .......................................................................................................................................
0 0
(10)
11.
Surtax (See instructions) ..........................................................................................................................................
0 0
(11)
12.
Amount of recapture (See instructions) ...................................................................................................................
0 0
(12)
13.
Total tax (Add lines 10 through 12) .........................................................................................................................
0 0
(13)
14.
Alternative Tax - Capital Gains (Schedule D Corporation and Partnership, Part IV, line 26) .....................................
0 0
(14)
15.
Tax Determined (Line 13 or 14, whichever is smaller) ....................................................................................................
0 0
(15)
16.
Recapture of investment credit claimed in excess (Schedule B Corporation and Partnership, Part I, line 3) .......
0 0
(16)
17.
Tax credits (Schedule B Corporation and Partnership, Part II, line 11) ........................................................................
0 0
(17)
18.
Tax liability before alternative minimum tax (Subtract line 17 from the sum of lines 15 and 16) .......................
0 0
(18)
19.
Alternative minimum tax (Schedule A Corporation and Partnership, Part V, line 32) .................................................
0 0
(19)
20.
Branch profits tax (Form AS 2879, line 11) ..........................................................................................................................
0 0
(20)
21.
Total Tax Liability (Add lines 18 through 20) .........................................................................................................
0 0
(21)
22.
Less: Other Payments and Withholdings (Schedule B Corporation and Partnership, Part III, line 7) ..................
0 0
(22)
23.
Balance of tax due (If line 21 is larger than line 22, enter the difference here,
otherwise, on line 25)
(a)
Tax ....................................................................................
0 0
(23a)
(b)
Interest ..............................................................................
0 0
(23b)
(c)
0 0
Surcharges ........................................................................
(23c)
(d)
Total (Add lines 23(a) through 23(c)) ....................................................................
0 0
(23d)
24.
Amount paid with this return .....................................................................................................................................
0 0
(24)
25.
Amount overpaid (If line 21 is smaller than line 22, distribute the difference between line A or B)
A. To be credited to estimated tax for (Year)____ ......................................................................................................
00
(25A)
B. To be refunded ............................................................................................................................................................
00
(25B)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 3