Form 8816 - Special Loss Discount Account And Special Estimated Tax Payments For Insurance Companies

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8816
Special Loss Discount Account and Special
Form
Estimated Tax Payments for Insurance Companies
OMB No. 1545-1130
(Rev. January 2010)
Department of the Treasury
Attach to tax return.
Internal Revenue Service
Name
Employer Identification Number
Part I
Special Loss Discount Amount
Accident year
1
Undiscounted unpaid losses
2
Discounted unpaid losses
3
Special loss discount limitation.
Subtract line 2 from line 1
Part II
Special Loss Discount Account (See instructions.)
4
Balance at the beginning of the year
5
Additions—section 847(4)
6
Subtractions—section 847(5)
7
Balance at the end of the year.
Add lines 4 and 5 and subtract line
6 from the result
Part III
Special Estimated Tax Payments (See instructions.)
8
Balance at the beginning of the year
9
Payments made for year
10
Prior section 847 payments
transferred to current year
11
Payments applied for year
12
Balance at the end of the year.
Add lines 8 through 10 and
subtract line 11 from the result
more members of the group is claiming
General Instructions
Specific Instructions
a section 847 deduction, enter “Form
Section references are to the Internal
Note: Line references are to the 2009
8816” and the amount in the margin
Revenue Code.
Form 1120-L, 2009 Form 1120-PC, and
near line 32b on Form 1120. This will
2009 Form 1120.
assist the IRS in properly accounting for
Purpose of form. Form 8816 must be
your Special Estimated Tax Payments.
filed by insurance companies that elect
Part I. Special Loss Discount
to take an additional deduction under
When to file. Attach Form 8816 to the
Amount
section 847.
Form 1120-PC, Form 1120-L, or Form
1120 filed for the tax year of the
Consolidated return. Each member of a
Accident year. Enter the four digit
additional deduction and for each
consolidated group claiming a section
accident year in the space provided at
subsequent tax year that has a
847 deduction must file a separate Form
the top of each column. For example,
remaining amount of unpaid losses
8816. Do not combine several taxpayers
enter accident year 2008 as 2008.
resulting from the deduction.
on one Form 8816. If a consolidated
return is filed on Form 1120 and one or
8816
For Paperwork Reduction Act Notice, see page 2.
Cat. No. 41382N
Form
(Rev. 1-2010)

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