Form 20-Ins - Oregon Insurance Excise Tax Return - 2013 Page 2
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14.Income after additions (line 7 plus line 13) ........................................................................................... 14
•
Subtractions
15. Amortization of past service credits ..............................................
15
•
16. Increases in certain reserves.........................................................
16
•
17. Total other subtractions (from Schedule ASC-CORP ,
see instructions)
....
17
•
18. Total subtractions (add lines 15 through 17) ..................................................................................
18
19. Income before net loss deduction (line 14 minus line 18) .................................................................. 19
If income is derived from sources both in Oregon and other states, carry amount on line 19
to Schedule AP-2, line 1. Please complete both Schedules AP-1 and AP-2.
•
20. Net loss deduction (attach schedule) ............................................................................................
20
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21. Oregon taxable income (line 19 minus line 20, or amount from Schedule AP-2, line 11) ..............
21
•
22. Calculated excise tax (see instructions). .......................................................................................
22
•
23. Minimum tax (based on Oregon sales, see instructions) ...............................................................
23
•
24. Tax (greater of line 22 or line 23) ....................................................................................................
24
•
25. Tax adjustment for installment sales interest (attach schedule) ....................................................
25
•
26. Tax before credits (line 24 plus line 25) ..........................................................................................
26
•
Credits
27. Total other credits (from Schedule ASC-CORP
.............................
27
)
(see instructions)
•
28. Fire insurance gross premiums tax credit .....................................
28
•
29.
29
OLHIGA (Oregon Life and Health Insurance Guaranty Association) .....
•
30. Total credits/offsets (add lines 27 through 29) ...............................................................................
30
•
Excise tax
31. Net excise tax (line 26 minus line 30, see instructions) .................................................................
31
•
32. 2013 estimated tax payments from Schedule ES below. Include payments made with your extension ....
32
•
33. Withholding payments made on your behalf from pass-through entity or real estate income ......
33
•
34. Tax due.
..........Tax due
34
Is line 31 more than line 32 plus line 33? If so, line 31 minus lines 32 and 33
•
35. Overpayment.
... Overpayment
35
Is line 31 less than line 32 plus line 33? If so, line 32 plus line 33, minus line 31
36. Penalty due with this return ...............................................................36
37. Interest due with this return ...............................................................37
•
38. Interest on underpayment of estimated tax (attach Form 37). ......
38
39. Total penalty and interest (add lines 36 through 38) .......................................................................... 39
40. Total due (line 34 plus line 39) ....................................................................................... Total due
40
41. Refund available (line 35 minus line 39) ............................................................................Refund
41
•
42. Amount of refund to be credited to 2014 estimated tax ............................................. 2014 credit
42
43. Net refund (line 41 minus line 42)................................................................................ Net refund
43
Schedule ES—Estimated Tax Payments or Other Prepayments
Name of payer
Payer FEIN
Date of payment
Amount paid
/
/
1. 1st Quarter
1
/
/
2. 2nd Quarter
2
/
/
3. 3rd Quarter
3
/
/
4. 4th Quarter
4
5. Overpayment of last year’s tax elected as a credit against this year’s tax ............................................................... 5
/
/
6. Payments made with extension or other prepayments for this tax year and date paid ............
6
7. Claim of right credit (attach computation and explanation) ...................................................................................... 7
8. Total prepayments (carry to line 32 above) ............................................................................................................... 8
Under penalty of false swearing, I declare that the information in this return and any attachments is true, correct, and complete.
Sign
Signature of officer
Signature of preparer other than taxpayer
License number of preparer
Here
X
•
X
Date
Date
Telephone number
(
)
Print name of officer
Print name of preparer
Title of officer
Address of preparer
Attach Oregon schedules and file with the Oregon Department of Revenue
Mail refund returns and no tax due returns to: Mail tax-to-pay returns with payment and payment voucher to:
Refund, PO Box 14777, Salem OR 97309-0960
Oregon Department of Revenue, PO Box 14790, Salem OR 97309-0470
Form 20-INS, page 2 of 3
150-102-129 (Rev. 10-13)
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