Form 63-20p - Premium Excise Return For Life Insurance Companies

Excise after credits

30 Excise due before voluntary contribution. Subtract line 29 from line 7 or line 15, whichever applies. Not less than “0”. . . . . . 30

31 Voluntary contribution for endangered wildlife conservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 31

32 Total excise plus voluntary contribution. Add lines 30 and 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 32

Payments

33 2006 overpayment applied to 2007 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 33

34 2007 Massachusetts estimated tax payments (do not include amount from line 33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 34

35 Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 35

36 Total payments. Add lines 33 through 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Refund or balance due

37 Amount overpaid. Subtract line 32 from line 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

38 Amount overpaid to be credited to 2008 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 38

39 Amount overpaid to be refunded. Subtract line 38 from line 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 39

40 Balance due. Subtract line 36 from line 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

41 M-2220 penalty 3 $ _______________________ ; Other penalties 3 $_______________________. . . . . . . . Total penalty 41

42 Interest on unpaid balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 42

43 Total payment due at time of filing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 43

Part 1. Domestic Life Premium Excise Calculation

–

Life insurance –

– Accident and health insurance –

Jurisdictions where

no insurance

Massachusetts

excise paid

Massachusetts

excise paid

11 All new and renewal (direct) premiums for

Massachusetts residents . . . . . . . . . . . . . . . . . . . . 1 3

12 Dividends applied to:

a Purchase paid-up additions . . . . . . . . . . . . . . . 2a 3

b Shorten premium paying period. . . . . . . . . . . . 2b 3

13 Total. Add lines 1 through 2b . . . . . . . . . . . . . . . . . 3

Deductions.

Include only what has been returned as receipts on this return or on a previous return.

14 Returned premiums but not including cash

surrender values (enclose schedule) . . . . . . . . . . . 4 3

15 Premiums for company employees’ group

life and accident and health plans if included

in line 1* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3

16 Gross premiums for authorized preferred

provider arrangements . . . . . . . . . . . . . . . . . . . . . . 6 3

17 Dividends:

a Paid in cash . . . . . . . . . . . . . . . . . . . . . . . . . . . 7a 3

b Applied in reduction of renewal premiums. . . . 7b 3

c Left to accumulate at interest. . . . . . . . . . . . . . 7c 3

d Applied to purchase paid-up additions . . . . . . . 7d 3

e Applied to shorten premium paying period . . . 7e 3

18 Total deductions. Add lines 4 through 7e . . . . . . . . 8

19 Amount taxable. Subtract line 8 from line 3 . . . . . . 9

10 Total life amount taxable. Add line 9, columns a and b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11 Total accident and health amount taxable. Add line 9, columns c and d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

*Premiums under the company employees’ group plans for annuity consideration and retirement benefits shall not be deducted.