Form 3725 - California Assets Transferred From Corporation To Insurance Company - 2015

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Assets Transferred from Corporation
TAXABLE YEAR
CALIFORNIA FORM
2015
3725
to Insurance Company
Attach to Form 100 or Form 100W .
Corporation (transferor) name
California corporation number
FEIN
Part I Assets Transferred from Corporation to Insurance Company
Section A – Information on Property Transferred
1 Was appreciated property transferred to an insurance company? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
If “Yes,” enter the insurance company’s name, California corporation number, and/or FEIN (see instructions), then
continue with line 2 . If “No,” do not complete this form .
Insurance company (insurer) name
California corporation number
FEIN
2 Does the insurance company use the transferred property in the active conduct of the insurer’s trade or business? . . . . . . . . . . .
  Yes
  No
If “Yes,”complete line 3 and Part II . Do not complete Parts III and IV . If “No,” complete Parts II and III .
Section B – Deferred Capital Gains. See instructions . Use additional sheets if necessary .
(a)
(b)
(c)
(d)
(e)
(f)
(g)
Taxable year
Description of
Location of
Date transferred
Fair market value
Adjusted basis of the
Amount of gain
property transferred
property transferred
(mm/dd/yyyy)
(FMV) at date
transferred property
deferred under R&TC
of transfer
on date of transfer
Section 24465
col . (e) less col . (f)
3
Part II Information on Stocks. See instructions .
4 Did the corporation transfer shares of stock to an insurer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
5 a Did the insurer transfer, or otherwise dispose of any transferred stock received in this taxable year or a prior taxable year? . .
  Yes
  No
If “Yes,” what was the cumulative percentage of transferred stock (measured by relative fair market value) that was
transferred or disposed of? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ______ .___%
b Was the insurer’s stock transferred or disposed of? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
If “Yes,” what was the cumulative percentage of the insurer’s stock (measured by relative fair market value) that was
transferred or disposed of? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ______ .___%
6 Did the insurer issue additional, or cancel existing shares of stock during the taxable year?
If “Yes,” answer lines 6a and 6b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
a Indicate the number of shares outstanding before such issuance or cancellation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
b Indicate the number of shares outstanding after such issuance or cancellation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
7 Did the transferred entity issue additional or cancel existing shares of stock during the taxable year? See instructions .
If “Yes,” answer lines 7a and 7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
a Indicate the number of shares outstanding before such issuance or cancellation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
b Indicate the number of shares outstanding after such issuance or cancellation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
8 Did the insurer or transferred entity issue another class of stock or type of equity interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
9 Did the equity interest in the transferred entity become worthless? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
FTB 3725
2015 Side 1
7431153
C1

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