Form 63-29a - Ocean Marine Profits Tax Return Page 5
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62016 FORM 63-29A, PAGE 5
Name of company
Federal Identification number
Supplementary schedule
(cont’d.)
– Classification of business within United States –
d. Marine
e. Marine, other than
f. All
g. Lines in col. g written
as per Section 29A
as per Section 29A
other classes
in Massachusetts
Premiums written
11 Direct (net of refunded) . . . . . . . . . . . . . . 1
12 Reinsurance assumed (net of returned) 2
*a _______ *b _______
13 Total. Add lines 1 and 2 . . . . . . . . . . . . . . 3
14 Deduct premiums on reinsurance ceded 4
**
15 Net premiums retained. . . . . . . . . . . . . . . 5
*Show separation into (a) authorized and (b) unauthorized reinsurance.
**Reconciliation of line 5, col. g with annual statement, page 14. Show pools, exchange, treaties and the amounts assumed and ceded through each.
Losses paid
16 On direct writings (salvage deducted) . . . 6
17 On reinsurance assumed (salvage
deducted) . . . . . . . . . . . . . . . . . . . . . . . . . 7
18 Total. Add lines 6 and 7 . . . . . . . . . . . . . . 8
19 Deduct recoveries on reinsurance ceded 9
10 Net losses paid . . . . . . . . . . . . . . . . . . . 10
Ocean marine expenses.
Col. a should agree with corresponding lines in Insurance Expense Exhibit.
– Incurred –
d. Ocean marine
business within
United States
11 Loss adjustment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Commission and brokerage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Other acquisition, field supervision and collection expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 General expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Taxes, licenses and fees excluding federal income and real estate taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Net United States ocean marine expenses incurred. Add lines 11d through 15d. Enter here and in Profit Schedule,
line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
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