Form 1366 - Insurance Company Annual Return For Sbt And Retaliatory Tax - 2002
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2Reset Form
2002
Michigan Department of Treasury
1366 (Rev. 11/02)
Insurance Company Annual Return for SBT and Retaliatory Tax
Check appropriate box.
This is an original return
Issued under P.A. 228 of 1975, as amended. Filing is mandatory.
This is an amended return
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2.
1. Company Name
Federal Employer ID No. or TR No.
4
3.
Address (No., Street)
Insurer Type (Check one)
Foreign
Domestic
City, State, ZIP
4
4.
State of Incorporation
Contact Person
Contact Person Phone No.
(2 letters)
ADJUSTED RECEIPTS
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5.
Enter the amount of the total company adjusted receipts for calendar year 2002
5.
APPORTIONMENT
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Enter Michigan gross direct premiums
6.
6.
4
Enter total gross direct premiums everywhere
7.
7.
8.
%
Michigan apportionment percentage. Divide line 6 by line 7
8.
9.
Apportioned Tax Base. Multiply line 5 by line 8
9.
DISABILITY INSURANCE EXEMPTION
Enter the disability insurance premiums written in Michigan, not including
10.
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credit insurance or disability income, OR $130,000,000, whichever is smaller
10.
Enter total gross direct premiums from all lines of
11.
11.
insurance carrier services everywhere
-
$180,000,000
12.
Subtract $180,000,000. If less than zero, enter zero
12.
Exemption reduction. Multiply line 12 by 2
13.
13.
Allowable exemption. Subtract line 13 from line 10. This amount can't be less than zero.
14.
14.
ADJUSTED TAX BASE. Subtract line 14 from line 9
15.
15.
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TAX BEFORE CREDITS. Multiply line 15 by 1.0735% (.010735)
16.
16.
CREDITS
Enter amounts paid from 1/1/2001 to 12/31/2001 to each of the following:
17.
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17a.
a. Michigan Workers' Compensation Placement Facility
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b.
b. Michigan Basic Property Insurance Association
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c.
c. Michigan Automobile Insurance Placement Facility
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d.
d. Property and Casualty Guaranty Association
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e.
e. Life and Health Guaranty Association
18.
Add lines 17a through 17e
18.
19.
This year's credit is 100%. Carry the amount from line 18 here
19.
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20.
Michigan Regulatory Fees Credit ______________ x 50%
20.
Add lines 19 and 20
21.
21.
Subtract line 21 from line 16. If less than zero, enter zero
22.
22.
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23a.
Contributions to COMMUNITY FOUNDATIONS
23a.
CREDIT. Enter the smaller of 50% of line 23a, $5,000 or 5% of the tax on line 16
23b.
b.
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23c.
Enter the code for the foundation contributed to here. See inst.
c.
Subtract line 23b from line 22
24.
24.
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25a.
Contributions to HOMELESS SHELTER/FOOD BANKS
25a.
CREDIT. Enter the smaller of 50% of line 25a, $5,000 or 5% of the tax on line 16
25b.
b.
Subtract line 25b from line 24
26.
26.
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27a.
Contributions to COLLEGES AND PUBLIC LIBRARIES
27a.
CREDIT. Enter the smaller of 50% of line 27a, $5,000 or 5% of the tax on line 26
27b.
b.
Subtract line 27b from line 26
28.
28.
Nonrefundable credits from C-8000MC, line 75. See instructions.
29.
29.
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TAX AFTER CREDITS. Subtract line 29 from line 28
30.
30.
Domestic insurers go to page 2, line 47. Foreign and alien insurers go to page 2, line 31.
PAYMENT
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61.
61. Write the amount entered on page 2, line 57
PAY THIS AMOUNT
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