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Instructions for Form 4905

Insurance Company Annual Return for Corporate Income and Retaliatory Taxes

Line 7: Enter returned premiums on canceled policies to the

Purpose

extent these premiums were included in line 5.

To calculate the tax liability and to claim credits for insurance

Line 8: Enter receipts on sales of annuities to the extent these

companies for both Corporate Income and Retaliatory Taxes.

receipts were included in line 5.

Line-by-Line Instructions

Line 9: Enter receipts on reinsurance premiums assumed to

Lines not listed are explained on the form.

the extent these receipts were included in line 5, and only if tax

was paid on the original premiums.

Do not enter data in boxes filled with Xs.

Amended Returns: To amend a current or prior year annual

CREDITS

Line 20: Enter the amounts paid to the listed facilities or

return, complete the Insurance Company Amended Return for

associations from January 1, 2011, to December 31, 2011, the

Corporate Income and Retaliatory Taxes (Form 4906) that is

applicable for that year, and attach a separate sheet explaining the

year immediately preceding the 2012 tax year, including

reason for the changes. Include an amended federal return or a

special assessments. Net the amounts paid and refunds received

signed and dated Internal Revenue Service (IRS) audit document,

during the 2011 tax year for the same facility or association.

if applicable. Do not include a copy of the original return with

If refunds received exceed the amount paid in the year for the

your amended return. Find detailed instructions on Form 4906.

same facility or association, enter zero.

Line 1: Enter the complete name and address including the

Line 22a: Enter the amount of Michigan Examination Fees

two-digit abbreviation for the country code. See the list of

paid in 2012 (under Michigan Compiled Law 500.224).

country codes in the Corporate Income Tax (CIT) Forms and

Retaliatory Instructions

Instructions for Insurance Companies (Form 4904).

For foreign and alien insurers only; domestic insurers skip

NOTE: Any refund or correspondence from this return will be

lines 26 through 40.

sent to the address used here. The taxpayer’s primary address

Do not mail this return with the Michigan Annual Financial

in Department of Treasury (Treasury) files, identified as the

Statement, and do not send the annual statement filing fee

legal address and used for all purposes other than refund and

with this return. The taxpayer will be billed separately for

correspondence on a specific CIT return, will not change unless the

the annual statement filing fee by the Office of Financial and

taxpayer files a Notice of Change or Discontinuance (Form 163).

Insurance Regulations (OFIR).

Line 2: Enter the taxpayer’s Federal Employer Identification

Number (FEIN). Be sure to use the same account number on

Foreign insurers must pay to Michigan the same type of

obligation a similar Michigan insurer is required to pay in the

all forms.

company’s state of domicile. Enter all items that are required

NOTE: The taxpayer must register before filing this

of a Michigan insurance company. Some taxes and obligations

form. Taxpayer’s are encouraged to register online at

imposed in other states may have no corresponding requirement

Taxpayers that register

in Michigan; however, this does not relieve the foreign insurer

with the State online receive their notification of the

from the obligation of computing and paying the tax.

registration within seven days.

Do not include the following Michigan assessments,

NOTE: If the taxpayer does not have an FEIN, the

or comparable assessments in the company’s state of

taxpayer must obtain an FEIN before filing. The Web site

incorporation, in the retaliatory calculation:

provides information on

• Michigan Workers’ Compensation Placement Facility

obtaining an FEIN.

• Michigan Basic Property Insurance Association

Returns received without a registered account number will

• Michigan Automobile Insurance Placement Facility

not be processed until such time as a number is provided.

• Property and Casualty Guaranty Association

Line 3: Check this box if the company is a foreign insurer.

• Michigan Life and Health Insurance Guaranty Association

Alien insurers are considered foreign insurers, unless their port

of entry is Michigan, in which case the company is considered

• Catastrophic Claims Association

domestic for the filing of this return.

• Assessment under Health Insurance Claims Assessment Act

(HICAA).

Line 4: Alien insurers, enter the two-letter postal code for the

Line 24: Enter the amount of recapture from line 22 of Form

U.S. state that is your port of entry.

Line 5: Enter all gross direct premiums written on property or

4902. Include a copy of Form 4902.

risk located or residing in Michigan.

Line 26: Enter the tax a Michigan company would pay in the

state of incorporation for the company’s Michigan business.

Line 6: Enter premiums on policies not taken to the extent

Attach a copy of the state’s tax form on which Michigan

these premiums were included in line 5.

premiums were reported.

Form 4905 - Insurance Company Annual Return For Corporate Income And Retaliatory Taxes - 2012 Page 11

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