Form 63-29a - Ocean Marine Profits Tax Return - 2013

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2013
Form 63-29A
Ocean Marine Profits
Tax Return
Massachusetts
Department of
Revenue
To be filed by domestic and foreign insurance companies which are subject to the provisions of Massachusetts General Laws, Ch. 63, section 29A.
For calendar year 2013 or taxable year beginning
2013 and ending
Name of company
Federal Identification number
Mailing address
City/Town
State
Zip
Name of treasurer
Organized under the laws of
Has the federal government changed your taxable income for any prior year which has not yet been reported to Massachusetts? 
Yes 
No
Profit Schedule
11 Net premiums on marine insurance written in the U.S. during the taxable year, meaning gross premiums less return
premiums, premiums on policies not taken and net premiums paid for reinsurance (from Supplementary Schedule,
line 5, col. d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Subtract unearned premiums on such marine insurance at end of taxable year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
13 Total. Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
14 Add unearned premiums on such marine insurance at the beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
15 Net earned premiums on marine insurance for taxable year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
16 Subtract net losses incurred (from Net Loss Schedule, line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
17 Subtract net expenses incurred (from Supplementary Schedule, line 17). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
18 Subtract dividends paid or credited to policyholders (from Dividend Deduction Schedule, line 5) . . . . . . . . . . . . . . . . . . . . . .
7
19 Balance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
8
10 Subtract federal income tax (from Federal Income Tax Deduction Schedule, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11 Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
10
12 Add excess of total of lines 7 and 10 over 40% of net premiums (from line 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13 Net underwriting profit on marine taxable year 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13
Under the penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.
Signature of appropriate corporate officer
Social Security number
Telephone number
Date
Signature of paid preparer
Employer Identification number
Date
Address of paid preparer
City/Town
State
Zip
If you are signing as an authorized delegate of the appropriate corporate officer, check here
and enclose Massachusetts Form M-2848, Power of Attorney.
The Privacy Act Notice is available upon request. Mail to: Massachusetts Department of Revenue, PO Box 7052, Boston, MA 02204.
Form code 374 / Tax type 0121

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