Form 1366 - Insurance Company Annual Return For Sbt And Retaliatory Tax - 2001

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Check appropriate box.
2001
This is an original return
Michigan Department of Treasury, SBT
1366 (Rev. 7-01)
This is an amended return
Insurance Company Annual Return for SBT and Retaliatory Tax
Issued under P.A. 228 of 1975, as amended. Filing is mandatory.
1.
2.
Company Name
Federal Employer ID No. or TR No.
4
3.
Address (No., Street)
Insurer Type (Check one)
4
Foreign
Domestic
City, State, ZIP
State of Incorporation
Contact Person
Contact Person Phone No.
4.
4
(2 letters)
ADJUSTED RECEIPTS
00
4
5
5.
Enter the amount of your total company adjusted receipts for calendar year 2001
APPORTIONMENT
00
4
6.
Enter your Michigan gross direct premiums
6
00
7.
Enter your total gross direct premiums everywhere
4
7
%
8
8.
Michigan apportionment percentage. Divide line 6 by line 7
00
9
9.
Apportioned Tax Base. Multiply line 5 by line 8
DISABILITY INSURANCE EXEMPTION
10.
Enter your disability insurance premiums written in Michigan, not including
00
credit insurance or disability income, OR $130,000,000, whichever is smaller
4
10
11.
Enter total gross direct premiums from all lines of
00
11
insurance carrier services everywhere
-
$180,000,000
00
00
12
12.
Subtract $180,000,000. If less than zero, enter zero
00
13.
Exemption reduction. Multiply line 12 by 2
13
00
14.
Allowable exemption. Subtract line 13 from line 10. This amount can't be less than zero.
14
00
15.
ADJUSTED TAX BASE. Subtract line 14 from line 9
15
4
00
16.
TAX BEFORE CREDITS. Multiply line 15 by 1.13% (.0113)
16
CREDITS
17.
Enter amounts you paid from 1/1/2000 to 12/31/2000 to each of the following:
00
4
a. Michigan Workers' Compensation Placement Facility
17a
00
b. Michigan Basic Property Insurance Association
4
b
00
4
c. Michigan Automobile Insurance Placement Facility
c
00
4
d. Property and Casualty Guaranty Association
d
00
e. Life and Health Guaranty Association
4
e
00
18.
Add lines 17a through 17e
18
00
19.
This year's credit is 100%. Carry the amount from line 18 here
19
00
4
20.
Michigan Regulatory Fees Credit ______________ x 50%
20
00
21.
Add lines 19 and 20
21
00
22.
Subtract line 21 from line 16. If less than zero, enter zero
22
00
4
23a.
Contributions to COMMUNITY FOUNDATIONS
23a
00
b.
CREDIT. Enter the smaller of 50% of line 23a, $5,000 or 5% of your tax on line 16
23b
4
c.
Enter the code for the foundation you contributed to here. See inst.
23c
00
24.
Subtract line 23b from line 22
24
00
4
25a.
Contributions to HOMELESS SHELTER/FOOD BANKS
25a
00
b.
CREDIT. Enter the smaller of 50% of line 25a, $5,000 or 5% of your tax on line 16
25b
00
26.
Subtract line 25b from line 24
26
00
4
27a.
Contributions to COLLEGES AND PUBLIC LIBRARIES
27a
00
b.
CREDIT. Enter the smaller of 50% of line 27a, $5,000 or 5% of your tax on line 26
27b
00
28.
Subtract line 27b from line 26
28
00
29.
Nonrefundable credits from C-8000MC, line 71. See instructions.
29
00
4
30.
TAX AFTER CREDITS. Subtract line 29 from line 28
30
Domestic insurers go to page 2, line 47. Foreign and alien insurers go to page 2, line 31.
PAYMENT
4
61
61 Write the amount you entered on page 2, line 57
PAY THIS AMOUNT
00

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