Form 63-29a - Ocean Marine Profits Tax Return printable pdf download

Massachusetts Department of Revenue

Form 63-29A

Ocean Marine Profits Tax Return

2016

For calendar year 2016.

Name of company

Federal Identification number

Mailing address

City/Town

State

Zip

Phone number

Name of treasurer

Organized under the laws of

Fill in if:

Amended return (see “Amended Return” in instructions)

Federal amendment

Federal audit

Fill in if federal government has changed your taxable income for any prior year which has not yet been reported to Massachusetts

Profit Schedule

11 Net premiums on marine insurance written in the U.S. during the taxable year, meaning gross premiums less

return premiums, premiums on policies not taken and net premiums paid for reinsurance (from Supplementary

Schedule, line 5, column d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1

12 Subtract unearned premiums on such marine insurance at end of taxable year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2

13 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3

14 Add unearned premiums on such marine insurance at beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4

15 Net earned premiums on marine insurance for taxable year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5

16 Subtract net losses incurred (from Net Loss Schedule, line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6

17 Subtract net expenses incurred (from Supplementary Schedule, line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 7

18 Subtract dividends paid or credited to policyholders (from Dividend Deduction Schedule, line 5) . . . . . . . . . . . . . . . . . . 3 8

19 Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

10 Subtract federal income tax (from Federal Income Tax Deduction Schedule, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 10

11 Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

12 Add excess of total of lines 7 and 10 over 40% of net premiums (from line 1). Not less than “0” . . . . . . . . . . . . . . . . . 3 12

13 Net underwriting profit on marine taxable year 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13

Declaration

Under penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.

Signature of appropriate corporate officer (see instructions)

Date

Social Security number

Phone number

Signature of paid preparer

Date

Employer Identification number

Address

If you are signing as an authorized delegate of the appropriate corporate officer, fill in oval

and enclose Massachusetts Form M-2848, Power of