Form Ib-33 - Gross Premium Tax Return Property And Casualty Companies - 2008 Page 3

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Legal Name
FEIN
Page 3, Form IB-33, Web, 1-09
Schedule C. Insurance Regulatory Charge
1.
Gross Premium Tax Liability
1.
(From Schedule B, Part 1, Total)
2.
Additonal Tax on Property Coverage Contracts
2.
(From Schedule F, Line 14)
3.
Total Premium Tax Liability
3.
Add Lines 1 and 2
4.
Insurance Regulatory Charge
4.
Multiply Line 3 by 5.5%
5.
Prior Year Credit Applied to 2008
5.
(From Schedule D, Line 1, Column 2)
6.
Insurance Regulatory Charge Installment Payments
6.
(From Schedule D, Line 5, Column 2)
7.
Total Insurance Regulatory Charge Due
$
7.
Line 4 minus Line 5 and Line 6, but not less than zero. If less than zero, enter amount on Line 8.
8.
8.
Overpayment
9.
9.
Amount of Line 8 to be Applied to 2009 Insurance Regulatory Charge
10. Insurance Regulatory Charge to be Refunded
10.
Line 8 minus Line 9
Schedule D. Installment Payments Made
(Do not include amounts from Line 1 on Lines 2 through 4)
(1)
(2)
(3)
Insurance
Additional Property
Gross Premium Tax
Regulatory Charge
Coverage Tax
1.
Prior Year Credit Applied to 2008
(Gross Premium Tax - from 2007 IB-33, Sch. B, Part 3, Line 11)
(Insurance Regulatory Charge - from 2007 IB-33, Sch. C, Line 8)
(Add’l Property Coverage Tax - from 2007 IB-33, Sch. F, Line 11)
2. Installment Payment made April 15, 2008
(Gross Premium Tax - from 2008 IB-34, Part 1, Line 4)
(Insurance Regulatory Charge - from 2008 IB-34, Part 3, Line 12)
(Add’l Property Coverage Tax - from 2008 IB-34, Part 2, Line 8)
3. Installment Payment made June 16, 2008
(Gross Premium Tax - from 2008 IB-35, Part 1, Line 4)
(Insurance Regulatory Charge - from 2008 IB-35, Part 3, Line 12)
(Add’l Property Coverage Tax - from 2008 IB-35, Part 2, Line 8)
4.
Installment Payment made October 15, 2008
(Gross Premium Tax - from 2008 IB-36, Part 1, Line 4)
(Insurance Regulatory Charge - from 2008 IB-36, Part 3, Line 12)
(Add’l Property Coverage Tax - from 2008 IB-36, Part 2, Line 8)
5.
Total Installment Payments Made in 2008
Add Lines 2 through 4
Schedule E. Guaranty Association Credit Available
Assessment Amount
Percentage
Amount of Credit
1.
Assessment Year 2003
20%
2.
Assessment Year 2004
20%
3.
Assessment Year 2005
20%
4.
Assessment Year 2006
20%
5.
Assessment Year 2007
20%
Total

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