Form Ct-33-A - Insurance Corporation Combined Franchise Tax Return 2002 - New York State Department Of Taxation And Finance Page 2

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Page 2a CT-33-A (2002)

Schedule A — Computation of combined allocation percentage

( If you do not claim an allocation, enter “100” on line 50; see instructions)

36 New York taxable premiums .........................................................................................................................................................................

37 New York ocean marine premiums ...............................................................................................................................................................

38 New York premiums for annuity contracts and for insurance for the elderly ................................................................................................

39 New York premiums on reinsurance assumed from authorized companies ................................................................................................

40 Total New York gross premiums

..............................................................................................................................

(add lines 36 through 39)

41 New York premiums ceded that are included on line 40 ..............................................................................................................................

42 Total New York premiums

..................................................................................................................................

(subtract line 41 from line 40)

43 Total everywhere premiums .........................................................................................................................................................................

44 Combined New York premium percentage

(in column E, divide line 42 by line 43)

...........................................................................................

45 Combined weighted New York premium percentage

...............................................................................................

(multiply line 44 by nine)

46 New York wages, salaries, personal service compensation, and commissions ...........................................................................................

47 Total everywhere wages, salaries, personal service compensation, and commissions ..............................................................................

48 Combined New York payroll percentage

..............................................................................................

(in column E, divide line 46 by line 47)

49 Total combined New York percentages

........................................................................................................................

(add lines 45 and 48)

50 Combined allocation percentage

(Divide line 49 by ten. If line 44 or 48 is “0”, see instructions.)

Schedule B — Computation and allocation of combined subsidiary capital

(see instructions)

51 Average fair market value of subsidiary capital ............................................................................................................................................

52 Current liabilities attributable to subsidiary capital .......................................................................................................................................

53 Net average fair market value of subsidiary capital .....................................................................................................................................

54 Net average value allocated to New York State

(enter column E amount in the first box on line 5)

Schedule C — Computation and allocation of combined business and investment capital

(see instructions)

55 Total assets from annual statement

......................................................................................................................................

(balance sheet)

56 Fair market value adjustment

...............................................................................................................

(if negative amount, use parentheses)

57 Nonadmitted assets from annual statement .................................................................................................................................................

58 Total combined assets

........................................................................................................................

(in column E, add lines 55, 56, and 57)

59 Current liabilities ...........................................................................................................................................................................................

60 Total combined capital

......................................................................................................................

(subtract line 59, column E, from line 58)

61 Combined subsidiary capital from line 53, column E ...................................................................................................................................

62 Combined business and investment capital

.....................................................................................................

(subtract line 61 from line 60)

63 Assets, excluding subsidiary assets included on line 53, held as reserves under New York State Insurance Law sections 1303, 1304,

and 1305

............................................................................................................................

(use same method to value assets as on line 58)

64 Adjusted combined business and investment capital (

......................................................................

subtract line 63, column E, from line 62)

65 Combined allocated business and investment capital

...

(multiply line 64 by the combined allocation percentage on line 50; enter here and in the first box on line 2)

Schedule D — Computation and allocation of combined entire net income

(see instructions)

66 Federal taxable income before net operating loss or operations loss (

..........................................................................

see instructions)

67 Dividends-received deduction

...........................................................................................................................

(used to compute line 66)

68 Dividend or interest income not included in line 66 (

...............................................................................................................

attach list)

69 Interest to stockholders:

less 10% or $1,000, whichever is larger ..............................................................................

70 Adjustment for gains or losses on disposition of property acquired before January 1, 1974

.......................................

(see instructions)

71 Deductions attributable to subsidiary capital (

.........................................................................................................................

attach list)

72 New York State franchise tax deducted on federal return

......................................................................................................

(attach list)

73 Amount deducted on your federal return as a result of a safe harbor lease ...........................................................................................

74 Amount that would have been required to be included on your federal return except for a safe harbor lease .......................................

75 ACRS or MACRS deductions used in the computation of federal taxable income

.......................................................

(see instructions)

Property and casualty insurance adjustments:

(see instructions)

76 Amount deducted from federal gross income on Form 1120-PC, under IRC section 847(1) ..................................................................

77 Unearned premiums at the end of the preceding tax year excluded from premiums earned as a result of the reduction in the

deduction for unearned premiums .......................................................................................................................................................

78 Amount of difference between unpaid losses and discounted unpaid losses at the end of the preceding tax year

(attach separate sheet) ...

79 Other additions

...............................................................................................................................

(attach explanation on separate sheet)

80 Total

.................................................................................................................................................

(add lines 66 through 79, in column E)

43002020094