Schedule 4i - Wisconsin Adjustments For Insurance Companies - 2010 Page 2

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2010 Schedule 4I
Page
18
Subtract line 17 from line 16 . If the amount on line 18 is positive, there is no
net business loss adjustment . If this amount is negative, complete lines 19 to 24 . . . . 18
19
Enter the total dividends received deduction from Schedule Y, computed as explained
in the instructions . Enter as a negative number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20
Enter the apportionment percentage from Form 4, line 8 . Combined group members:
Enter the Wisconsin percentage from Form 4A, Part II, column c, or if a member of a
.
100% Wisconsin group, enter "100 .0000% ." . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
%
2 1
Multiply line 19 by line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22
Combined group members: Enter the dividends received deduction
attributable to dividends reported on Form 4N, computed as explained in the
instructions . Enter as a negative number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
23
Add lines 21 and 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24
If the absolute value of the amount on line 23 exceeds the absolute value of the
amount on line 18, enter the amount from line 18 as a positive number . If the absolute
value of the amount on line 18 exceeds the absolute value of the amount on line 23,
enter the amount from line 23 as a positive number . Enter or include this amount on
Form 4, line 11d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Part IV Tax Adjustment for Insurance Companies
25
Insurance company's Wisconsin net income from Form 4, line 13 .
Combined group members: Use the amounts on Form 4M
to compute the insurance company's share of the combined
Wisconsin net income . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
26
Multiply line 25 by 7 .9% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
27a Insurance company's gross premiums as defined in s . 76 .62, Wis . Stats . . . . . . . . . . . 27a
27b Multiply line 27a by 2% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27b
28a Wisconsin income realized from lottery prizes as reported on Form 4N, line 5 . . . . . . . . 28a
28b Multiply line 28a by 7 .9% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28b
29
Add lines 27b and 28b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
30
If line 29 is greater than line 26, enter $0 on line 30 . If line 29 is less than line 26,
subtract line 29 from line 26 and enter the result on line 30 . This is the tax
adjustment to enter or include on Form 4, line 14b . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
In addition to the copy of the federal return filed with the Form 4, you must
file a copy of any related schedule and a copy of your annual statement.
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