Form Cdi Fs-003 - Title Insurance Tax Return - 2014
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3State of California
Department of Insurance
TITLE INSURANCE TAX RETURN
CDI FS-003 (REV 9/2014)
2014
FOR CALENDAR YEAR
TAX DUE DATE APRIL 1, 2015
Name of Insurer
Fed Tax I.D. No.
CA Perm No.
NAIC No.
Mailing Address
EFT Taxpayer I.D. No.
City, State, Zip
Method of Tax Payment
No Payment
Telephone & Fax #
Check
State of Domicile
EFT
If New Company, check here
If Name Change, check here
If Final Return, check here
If Amended Return, check here
and indicate the effective date of the final transaction.
and indicate the date when it was amended.
STATEMENT OF TAXABLE PREMIUMS AND TAXES DUE DURING CALENDAR YEAR 2014
CDI Use Only
1.
Gross All Inclusive Title Insurance Premiums
1.
1.1
Deduct Sum Retained by Underwritten Title Companies
1.1
1.2
Net Taxable Insurance Premiums
1.2
2. All Income Received on Reinsurance Assumed without deducting for reinsurance ceded
2.
3. All Other Income Pursuant to RTC 12231 & 12232
3.
4. Total Taxable Income
4.
2.35%
5.
Tax Rate
5.
6.
2014 Annual Tax
6.
7.
Low Income Housing Credit
7.
8.
CA CDFI Credit (COIN)
8.
Prepayments Made During the Reporting Year of 2014
9.
a.
Overpayment applied from prior ye
b.
First Quarter (Balance paid)
c.
Second Quarter
d.
Third Quarter
e.
Fourth Quarter
f.
Total Prepayments
9f.
10.
Total Credits & Prepayments Made
10.
11.
2014 Tax Due - If Line 6 is greater than Line 10
11.
12.
2014 Tax Overpayment- If Line 10 is greater than Line 6
12.
The tax overpayment (line 12) may be applied to the 2015 first
quarter prepayment and the 2014 retaliatory tax.
A Refund SHALL NOT be applied to the 2015 second quarter
prepayment or any future tax payment unless prior approval
has been granted.
13.
2015 First Quarter Prepayment
13.
a.
2014 Tax Overpayment applied to the 1st Quarter Prepaymena.
b.
2015 First Quarter Prepayment Balance Due
13b.
14.
2014 Retaliatory Tax
14.
a.
2014 Tax Overpayment applied to the Retaliatory Tax
a.
b.
2014 Retaliatory Tax Balance Due
14b.
15.
Tax Refund
15.
Line 11
2014 Tax Due
Line 13b
2015 First Quarter Prepayment Balance Due
Line 14b
2014 Retaliatory Tax Balance Due
Each Payment must be paid separately and should
NOT be combined to make one lump sum payment
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