Form Ct-33-A - Life Insurance Corporation Combined Franchise Tax Return - 2013 Page 4

Page 3a CT-33-A (2013)

Schedule D — Computation and allocation of combined ENI

(continued; see instructions)

Subtractions

76 Interest, dividends, and capital gains from subsidiary capital

....................................................................

(attach list; see instructions)

77 Fifty percent of dividends from nonsubsidiary corporations

......................................................................

(attach list; see instructions)

78 Gain on installment sales made before January 1, 1974

............................................................................

(attach list; see instructions)

79 Combined New York operations loss or NOL

...................................................

(attach statement showing computation; see instructions)

80 Amount included on your federal return as a result of a safe harbor lease

................................................................

(see instructions)

81 Amount that could have been deducted on your federal return except for a safe harbor lease

................................

(see instructions)

82 Total amount of New York depreciation allowed under Article 33, section 1503(b) from Form CT-399

.....................

(see instructions)

83 Other subtractions

S-10

............................................................................................

(see instructions)

84 Total combined subtractions

...........................................................................................................

(add column E, lines 76 through 83)

85 Combined ENI

...........................................................................................................................................

(subtract line 84 from line 75)

86 Combined allocated ENI

...................

(multiply line 85 by combined allocation percentage on line 48; enter here and in the first box on line 1)

Schedule E — Computation and allocation of combined alternative base

87 Officer salaries and other compensation

...................................................................................................................

(see instructions)

88 Combined alternative base

...............................................................................................................

(add column E, line 85 and line 87)

89 Statutory deduction (

) ...................................................................................................................................................

see instructions

90 Combined alternative base minus deduction

(subtract line 89 from line 88) .......................................................................................................

91 Combined alternative base multiplied by 30%

..................................................................................................

(multiply line 90 by 0.3)

92 Combined allocated alternative base

(multiply line 91 by combined allocation percentage on line 48; enter here and in the first box on line 3)

Schedule F — Computation of combined premiums

(see instructions)

Combined life insurance company premiums taxable under Article 33 section 1510

93 Life insurance premiums ......................................................................................................................................................................

94 Accident and health insurance premiums ...........................................................................................................................................

95 Other insurance premiums

.................................................................................................................................................

(attach list)

96 Total combined life insurance company premiums

(add column E, lines 93 through 95; enter here and in the first box on line 7) ...................

Combined life insurance company premiums included in the tax limitations computed under Article 33 section 1505

97 Life insurance premiums ......................................................................................................................................................................

98 Accident and health insurance premiums ...........................................................................................................................................

99 Other insurance premiums ..................................................................................................................................................................

100 Total combined life insurance company premiums subject to the floor limitation on tax under section 1505(b)

..............................................................................................

(add column E, lines 97 through 99; enter here and in the first box on line 9)

Insurance corporations who receive more than 95% of their premiums from:

101 Annuity contracts, ocean marine insurance, and group insurance on the elderly

......................................................

(see instructions)

102 Total combined life insurance company premiums subject to the limitation on tax under section 1505(a)(2)

(add lines 100 and 101,

.................................................................................................................................

column E; enter here and in the first box on line 14)

Schedule G — Computation of combined issuer’s allocation percentage

(see instructions)

103 New York gross direct premiums .........................................................................................................................................................

104 Total gross direct premiums.................................................................................................................................................................

105 Combined issuer’s allocation percentage

..............................................

(divide column E, line 103 by line 104; enter here and on line 33)

430004130094