Form 6i - Wisconsin Adjustment For Insurance Companies - 2015
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2015 Form 6I - Wisconsin Adjustment for Insurance Companies
Designated Agent Name
Federal Employer ID Number
Corporation Name:
Combined
FEIN:
Totals
Part I Additions Specific to Insurance Companies
1
Loss carryforward deducted in the calculation
of federal taxable income . . . . . . . . . . . . . . . . .
1
.00
.00
.00
1
.00
2
Dividend income received to the extent not
included in the amount on Form 6, line 1 . . . . .
2
.00
.00
.00
2
.00
3
Additional federal deduction for insurers
required to discount unpaid losses . . . . . . . . . .
3
.00
.00
.00
.00
3
4
Add lines 1 through 3 . Enter this amount on
Form 6, Part II, line 2i . . . . . . . . . . . . . . . . . . . .
4
4
.00
.00
.00
.00
Part II Nontaxable Income from Life Insurance
Operations
5
Insurance company’s federal taxable income as
reported or included on Form 6, Part II, line 1 . .
5
.00
.00
5
.00
.00
6
Insurance company’s total addition modi-
fications from Form 6, Part II, line 2k . . . . . . . . .
6
.00
.00
.00
.00
6
7
Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . .
7
7
.00
.00
.00
.00
8
Insurance company’s total subtraction modi-
fications from Form 6, Part II, lines 4a through
4l plus line 4m-e . . . . . . . . . . . . . . . . . . . . . . . .
8
.00
.00
.00
8
.00
9
Subtract line 8 from line 7 . . . . . . . . . . . . . . . . .
9
.00
.00
.00
9
.00
10a Enter net gain from operations other than life
insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10a
.00
.00
.00
10a
.00
10b Enter total net gain from operations . . . . . . . . . 10b
10b
.00
.00
.00
.00
11
Divide line 10a by line 10b and enter result as
%
.
%
.
%
.
%
.
a percentage (see instructions) . . . . . . . . . . . . . 11
11
12
Multiply line 9 by line 11 . . . . . . . . . . . . . . . . . . 12
.00
.00
.00
12
.00
13
Subtract line 12 from line 9 . Enter this amount
Form 6, Part II, line 4n . . . . . . . . . . . . . . . . . . . . 13
.00
.00
13
.00
.00
IC-402
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