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. September 2013)
Information about Form 8816 and its instructions is at
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
.
.
Special Loss Discount Account (See instructions.)
Part II
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 .
General Instructions
Specific Instructions
is claiming a section 847 deduction,
enter “Form 8816” and the amount on
Section references are to the Internal
Note: All line references to Form 1120-L,
the dotted line next to line 13 on Form
Revenue Code.
Form 1120-PC, and Form 1120 are to
1120, Schedule J, Part II. This will assist
the 2012 forms.
the IRS in properly accounting for your
Purpose of form. Form 8816 must be
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
the top of each column. For example,
remaining amount of unpaid losses
Form 8816. Do not combine several
enter accident year 2011 as 2011.
resulting from the deduction.
taxpayers on one Form 8816. If a
consolidated return is filed on Form 1120
and one or more members of the group
8816
For Paperwork Reduction Act Notice, see page 2.
Form
(Rev. 9-2013)
Cat. No. 41382N

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