Schedule 4i - Wisconsin Adjustments For Insurance Companies - 2010
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4I
Wisconsin Adjustments for
Schedule
Insurance Companies
2010
File with Wisconsin Form 4
Wisconsin Department
of Revenue
Read instructions before filling in this form
Corporation Name
Federal Employer ID Number
Part I Additions Specific to Insurance Companies
1
Loss carryforward deducted in the calculation of federal taxable income . . . . . . . . . . . 1
2
Dividend income received to the extent not included in the amount on Form 4,
line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3
Additional federal deduction for insurers required to discount unpaid losses . . . . . . . . 3
4
Add lines 1 through 3 . Enter this amount on Schedule V, line 11 . . . . . . . . . . . . . . . . . 4
Part II Nontaxable Income from Life Insurance Operations
5
Insurance company's federal taxable income as reported or included on
Form 4, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6
Insurance company's total addition modifications from Schedule V, line 13 . . . . . . . . . 6
7
Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8
Insurance company's total subtraction modifications from Schedule W
through line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9
Subtract line 8 from line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10a Enter net gain from operations other than life insurance . . . . . . . . . . . . . . . . . . . . . . . 10a
10b Enter total net gain from operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10b
.
11
Divide line 10a by line 10b and enter result as a percentage (see instructions) . . . . . . 11
%
12
Multiply line 9 by line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13
Subtract line 12 from line 9 . Enter this amount on Schedule W, line 14 . . . . . . . . . . . . 13
Part III Net Business Loss Adjustment for Insurance Companies
14
Enter net income or loss from Form 4, line 9 . Combined group members:
Enter amount from the insurance company's Form 4M, line L1, net of any
amount on line L2 of that same form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15
Enter the net income or loss from Form 4, line 10 . Combined group members:
Enter amount from the insurance company's Form 4M, line M . . . . . . . . . . . . . . . . . . . 15
16
Add lines 14 and 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17
Combined group members: Enter net capital loss adjustment from Form 4M,
line N (enter as a positive amount) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
IC-020C
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Parent category: Financial