Schedule 8 - Class B - Idaho Life And Health Insurance Guaranty Association Credits - 2011

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SCHEDULE 8 – CLASS B (Assessed in 2011)
IDAHO LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION CREDITS
1. 2011 Class B Consolidated Health Assessment (ASSESSED 09/26/2011)
A. Maximum of 20% of Portion Paid in 2011 (Expires with Tax Due 03/01/2016)
Insert this total on Page 4 of 7, Schedule C, Line 3
$__________________
NOTE: ITEMIZE ONLY THE ACTUAL CREDIT BGEING TAKEN FOR EACH ASSESSMENT. DO
NOT
REPORT
ORIGINAL
AMOUNTS
PAID
OR
BALANCES
REMAINING
ON
ASSESSMENTS.
NOTE: YOUR COMPANY MAY TAKE ONLY 20% OF THE CREDIT IN EACH OF THE FIVE
YEARS FOLLOWING THE CALENDAR YEAR IN WHICH THE ASSESSMENT WAS PAID.
IF YOUR COMPANY DOES NOT TAKE THE 20% IN THE YEAR IT IS AVAILABLE, IT
WILL LOSE THAT 20%.
INS-PTX-GACREDITS (10-11)

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