Form 3725 - California Assets Transferred From Corporation To Insurance Company - 2015 Page 2

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Part III Assets Transferred from Insurance Company. See instructions .
  Yes
  No
10 Did the ownership of the holder of the transferred property change during the taxable year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If “Yes,” go to line 11 . If “No,” skip line 11 .
11 Is the holder of the property held by an insurer in the commonly controlled group of the transferor or a member of the
taxpayer’s combined reporting group? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
If “Yes,” go to line 12 . If “No,” complete Part IV .
12 Did the insurer dispose of, in whole or in part, any transferred property during the taxable year? . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
If “Yes,” go to line 13 . If “No,” do not complete Part IV .
13 Did the insurer dispose of any transferred property to a member of the corporation/transferor’s combined
reporting group or to another insurer in the transferor’s commonly controlled group during the taxable year? . . . . . . . . . . . . . .
  Yes
  No
If “Yes,” go to line 14 . If “No,” the gain is taxable, complete Part IV .
14 Does the transferee in the combined reporting group or commonly controlled group use the property it
received in the active conduct of a trade or business? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
If “Yes,” do not complete Part IV . If “No,” the gain is taxable, complete Part IV .
Part IV Capital Gains and Losses
Section A – Short-Term Capital Gains and Losses - Assets Held One Year or Less. See instructions . Use additional sheets if necessary .
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
Taxable
Description of
Location of
Percentage
Date
Amount realized or
Adjusted basis of
Gain (loss)
Year
property
property
of property
(mm/dd/yyyy)
FMV
property
col . (f) less col . (g)
15
16 Short-term capital gains (losses). Total amounts in column (h) . Enter here and on Form 100 or Form 100W, Side 6,
Schedule D, Part I, line 1, column (f) or Schedule D (100S), Section A or Section B, Part I, line 1, column (f) .
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 _______________
Section B – Long-Term Capital Gains and Losses - Assets Held More Than One Year. See instructions . Use additional sheets if necessary .
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
Taxable
Description of
Location of
Percentage
Date
Amount realized or
Adjusted basis of
Gain (loss)
Year
property
property
of property
(mm/dd/yyyy)
FMV
property
col . (f) less col . (g)
17
18 Long-term capital gains (losses). Total amounts in column (h) . Enter here and on Form 100 or Form 100W, Side 6,
Schedule D, Part II, line 5, column (f) or Schedule D (100S), Section A or Section B, Part II, line 4, column (f) .
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 _______________
Under penalties of perjury, I declared that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete .
Title
Date
Telephone
Signature of
corporation
Sign
(transferor)
Here
(
)
officer
Title
Date
Telephone
Signature
(
)
of insurer
Side 2
FTB 3725
2015
C1
7432153

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