Fillable Form M11h - Insurance Premium Tax Return For Hmos 2012 (Page 3 of 3) in pdf

2012 Form M11H Instructions

(continued)

Business Information

Information and Assistance

Late Filing. Add a late filing penalty to

the late payment penalty if your return is

Changes

Website:

not filed by the due date. The penalty is

Email:

insurance.taxes@state.mn.us

Be sure to let us know within 30 days if you

5 percent of the unpaid tax. When added

Phone:

651-556-3024 (TTY: Call 711 for

change mailing addresses, phone numbers,

to the late payment penalty, the maximum

Minnesota Relay)

or any other business information. To do

combined penalty is 20 percent.

so, to go our website, login to e-Services

We’ll provide information in other formats

Payment Method. If you are required to

and update your profile information. By

upon request to persons with disabilities.

pay electronically and do not, an additional

notifying us, we will be able to let you know

5 percent penalty applies to payments not

of any changes in Minnesota tax laws and

made electronically, even if a paper check is

filing requirements.

sent on time.

Interest. You must pay interest on the

unpaid tax plus penalty from the due date

Worksheet Instructions

until the total is paid. The interest rate for

calendar year 2013 is 3 percent. The rate

may change for future years.

Step 5

Also, the second installment will then be

Payments of estimated tax are applied

underpaid by $100 (assuming that the

To figure how much interest you owe, use

against any underpayments of required in-

second payment is $200) until sufficient

the following formula with the appropriate

stallments in the order that the installments

repayments are received to eliminate the

interest rate:

were due.

underpayment.

Interest =

For example, if your first installment is

If more than one payment has been made

(tax + penalty) × # of days late × interest

underpaid by $100 and you deposit $200

for a required installment, attach a separate

rate ÷ 365

for your second installment, $100 of your

computation for each payment.

second payment is applied to the first

Credit the excess of any overpayment for

installment. The additional charge for the

a period on step 5 of the next payment

first installment is computed from the first

period.

installment’s due date to the date the second

payment is made.

Step 10

If there is no underpayment on step 7, enter

“none” on step 10 for that period.

Worksheet: Additional Charge for Underpaying Estimated Tax for 2012

1 Enter 80 percent of the total annual tax liability from line 7 of your 2012 Form M11H . . . . . . . . . . . . 1

2 Enter the amount from line 3 of your 2011 Form M11H. If you were not required to file a 2011

return or if your total annual tax liability was $500 or less, you do not owe an additional charge . . . . 2

Due Dates

March 15

June 15

Sept. 15

Dec. 15

3 Enter one-fourth of step 1 or step 2 (whichever is less)

in each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Amounts paid on or before the due date for each period . Include

credits applied, such as prior year’s overpayment . . . . . . . . . . . . . . . 4

5 Overpayment of previous installment (see worksheet instructions) . 5

6 Add steps 4 and 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

7 Underpayment (or overpayment) . Subtract step 6 from step 3 . . . . . 7

8 Date underpayment is paid or March 1, 2013, whichever is earlier . . . .8

9 Number of days from the due date to the date on step 8 . . . . . . . . . 9

10 Additional charge (step 9 ÷ 365 × interest (see below) × step 7) . . 10

11 TOTAL. Add amounts in each column on step 10 .

Enter the result here and on Form M11H, line 10a . . . . . . . . . . . . . 11

If step 11 is zero, keep this worksheet for your records . Do not send it with your return .

If it is more than zero, attach a copy of the worksheet to your Form M11H .

Interest: 2012 = .03; 2013 = .03

Form M11h - Insurance Premium Tax Return For Hmos 2012 Page 3

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