Form Ip-1 - Insurance Premium Tax Return - 2007 (Page 2 of 2) in pdf

COMPUTATION OF LIFE, ACCIDENT & HEALTH AND ANNUITY INSURANCE PREMIUM TAX

Use Lines 17-35 for these insurance types only.

State of Incorporation

State of Vermont

Basis

17. Gross direct life premiums collected during the year.

17.

18. If a Vermont company, indicate gross direct life premiums written

and collected which are not taxed by other states.

18.

19. Gross direct accident and health premiums collected during the year

19.

20. TOTAL PREMIUMS (Add Lines 17 - 19)

20.

21. Life dividends applied on renewal premiums

21.

22. Life dividends paid in cash

22.

23. Life dividends left to accumulate

23.

24. Dividends paid to policyholders on accident and health policies

24.

25. Other deductions (please specify)

25.

26. TOTAL DEDUCTIONS (Add Lines 21 - 25)

26.

27. NET TAXABLE PREMIUMS (Subtract Line 26 from Line 20)

27.

28. Tax rate of __________% (use 2% for Vermont companies)

28.

29. Gross annuity premium and considerations during the year

29.

30. Annuity deductions (please specify)

30.

31. TAXABLE ANNUITY PREMIUMS & CONSIDERATIONS

(Subtract Line 30 from Line 29)

31.

32. Tax rate of ___________% (use 0% for Vermont companies)

32.

33. LIFE, ACCIDENT and HEALTH & ANNUITY PREMIUM TAX:

(Add Lines 28 and 32)

33.

34. Credit for payments to the Vermont Life & Health

Insurance Guaranty Association

34.

35. NET PREMIUM TAX DUE (Subtract Line 34 from Line 33 and enter on

Line 10). Do not carry excess credit to Line 10.

35.

INSTRUCTIONS

1. Payments to the Vermont Life & Health Insurance Guaranty Association are DEDUCTIBLE as a credit against your Vermont

Life, Accident & Health and Annuity Insurance Premium Tax liability [8 V.S.A., §4167 (b)]. This is the specific provision for

credit.

2. Payments to the Vermont Property and Casualty Insurance Association are NOT DEDUCTIBLE as a credit against your

Vermont Insurance Premium Tax liability (8 V.S.A., Chapter 101, Subchapter 9). There is no provision for credit.

3. All payments to the Vermont Life & Health Insurance Guaranty Association are allowable in the computation of the credit,

including the $25.00 (Class A) assessment.

4. The credit applies up to the tax liability as shown on Line 33. Refunds are not due on any excess credit above that of the tax

liability amount on Line 33.

5. The credit is 20% of the payment each year starting in the year following that year for which the payment was made to the

association.

6. Please submit, as proof of payment, copies of your cancelled check and the return on which the credit is first claimed.

7. Copies of the Certificates of Contribution(s) used to compute the credit must accompany the return. There may be several certifi-

cates in any given year with one for each impaired company.

8. Attach schedule of computation of credits claimed (with any Vermont Housing Credits outlined and included).

9. The disclosure of your Social Security or Federal ID # is mandatory, authorized by 42 U.S.C. 405(c)(2)(C), and used to identify

taxpayers affected by Vermont tax laws.

10. Corporations organized under N.Y. law are required to attach a copy of their N.Y. Corp. Franchise Tax Return with this return.

For assistance, call the Vermont Department of Taxes, Miscellaneous Tax Division, at (802) 828-2551, option 4.

Form Ip-1 - Insurance Premium Tax Return - 2007 Page 2

Related Articles

Related forms

Related Categories