Form Dl-2 - Investment Privilege Excise Return For Domestic Life Insurance Companies - 1999

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1999
Form DL-2
Massachusetts
Investment Privilege Excise Return
Department of
for Domestic Life Insurance Companies
Revenue
For calendar year 1999 or taxable year beginning
, 1999 and ending
Name of company
Federal Identification number
¨
¨
Mailing address
DOR use only
Name of treasurer
Check applicable investment income
¨
12%
14% tax rate
Has the Federal Government changed your taxable income for any prior year which has not yet been reported to Massachusetts?
Yes
No.
If “Yes,” report such change on Form 355FC within three months after the final federal determination.
Computation of Excise.
Attach a copy of Schedule T of NAIC Annual Statement
Income and Excise Before Credits
Use whole dollar method
11 Admitted assets as of December 31, 1999 from Annual Statement, page 2 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . ¨ 1
$
× applicable rate ¨ 2
12 Massachusetts taxable investment income (Schedule C, line 9) . . . . . . . . . . . . ¨ $ ________________
$
Credits
13 Credit if line 1 is less than $240,000,000. Enter $500 for each $1,000,000 (disregard a fraction thereof)
that line 1 is below $240,000,000, up to a maximum of $20,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 3
$
14 Economic Opportunity Area Credit (Schedule EOA, line 9). If this credit was claimed on Form DL-1 or
Form 176-I, do not claim it on this form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 4
$
15 Full Employment Credit (Schedule FEC). If this credit was claimed on Form DL-1 or Form 176-I, do not claim it
on this form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 5
$
Excise After Credits
16 Investment privilege excise due before voluntary contribution.
Subtract total of lines 3, 4 & 5 from line 2. Not less than “0” . . . 6
$
17 Voluntary contribution for endangered wildlife conservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 7
$
18 Total excise plus voluntary contribution. Add line 6 and line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 8
$
Payments
19 1997 overpayment applied to 1998 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 19
$
10 1998 Massachusetts estimated tax payments (do not include amount from line 8) . . . ¨ 10
$
11 Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 11
$
12 Total payments. Add lines 9, 10 and 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
$
Refund or Balance Due
13 Amount overpaid. Subtract line 8 from line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
$
14 Amount overpaid to be credited to 1999 estimated tax. . . . . . . . . . . . . . . . . . . . . . . . ¨ 14
$
15 Amount overpaid to be refunded. Subtract line 14 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 15
$
16 Balance due. Subtract line 12 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
$
17 M-2220 penalty ¨ $_______________________ ; Other penalties ¨ $ ______________________ . . . . . . . . Total penalty 17
$
18 Interest on unpaid balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 18
$
19 Total payment due at time of filing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 19
$
Declaration
Under the penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which he/she has
knowledge.
Signature of appropriate corporate officer (see instructions)
Social Security number
Title
Date
Individual or firm signature of preparer
Employer Identification number
Address
Date
¨
If you are signing as an authorized delegate of the appropriate corporate officer, check here
and attach Mass. Form M-2848, Power of Attorney.
Mail to: Massachusetts Department of Revenue, PO Box 7052, Boston, MA 02204. Make check or money order payable to the Commonwealth of
Massachusetts.
Form Code 366 Tax Type 0124

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