Form 83-391-14-8-1-000 - Mississippi Insurance Company Income Tax Return - 2014 Page 4

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Form 83-391-14-8-4-000 (Rev. 05/14)
Mississippi
Insurance Company Income Tax Return
2014
Page 4
FEIN
A MISSISSIPPI
B COMPANY-WIDE
PART III: DEDUCTIONS APPORTIONED
.
21A
21B
21 Non-allocable loss adjustment expenses
.
00
00
22A
22B
.
.
22 Total apportioned expenses (from page 4, part IV, line 3)
00
00
23 Total allocated and apportioned deductions (line 20 plus
line 21 plus line 22; enter on page 2, line 15)
23A
23B
.
.
00
00
PART IV: DEDUCTIONS APPORTIONED (FROM ANNUAL STATEMENT)
Expenses must be separately apportioned. Attach supplementary pages to return as needed.
Line
A Column (X9)
Page
Description
B Less Allocable
C Balance
Expenses
Apportionable
1
Totals (total column A minus total column B)
.
%
2
Applicable expense apportionment ratio (from page 3, part I)
3
Total apportioned to Mississippi (multiply line 1, column C by
line 2, enter amount on page 4, part III, line 21)
PART V: RETALIATORY TAXES PAID
(MISSISSIPPI CORPORATIONS ONLY)
Itemize retaliatory taxes paid by state and attach copies of returns documenting amounts. Attach supplementary schedules as needed.
A Taxing Authority
B Amount
A Taxing Authority
B Amount
1 Total amounts (total amounts from
column B; enter amount on page
1, line 3)

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