Form Rct-124 - Underwriting Profits Tax - Domestic And Foreign Marine Insurance Page 2
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41240012205
Revenue ID
RCT-124
PAGE 2 OF 4
(06-12)
TOTAL UNDERWRITING PROFIT ON MARINE BUSINESS
TRANSACTED WITHIN PENNSYLVANIA
USE WHOLE DOLLARS ONLY
1.
Net Marine Insurance Premiums, less Net Reinsurance Premiums, written within
1.
the U.S. (Schedule A, Column 6, Item d)
2.
Plus: Net Unearned Marine Premiums on U.S. business at beginning of four-year
2.
period (Schedule D, Column 7, Item a)
3.
Total (Line 1 plus Line 2)
3.
4.
Less: Net Unearned Marine Premiums on U.S. business at end of four-year period
4.
(Schedule D, Column 7, Item d)
5.
Net Marine Premiums Earned (Line 3 minus Line 4)
5.
6.
Net Marine Losses incurred on business written within the U.S.
6.
(Schedule E, Column 6, Item d)
7.
Specific Marine Expenses incurred (Schedule F, Column 8, Item d)
7.
8.
Portion of general expenses chargeable to U.S. Marine Premiums
8.
(Schedule G, Item e multiplied by Schedule G, Column 8, Item d)
9.
Total Deduction (Line 6 plus Line 7 plus Line 8)
9.
10. Net Marine Underwriting Profit on business written within the U.S.
10.
(Line 5 minus Line 9)
11. Apportionment (from Schedule G, Item f)
11.
12. Net Marine Underwriting Profit on business written within Pennsylvania for
12.
three years (Line 10 multiplied by Line 11)
13. Average Net Marine Underwriting Profit on business within Pennsylvania for one year
13.
(Line 12 times one-third – See Instructions)
14. Tax (Line 13 times tax rate – See Instructions)
14.
*1 24001 2205*
Preparer’s Information:
Firm Name
Individual Preparer Name
Firm FEIN
Phone
Address
Email
City
Social Security Number
or PTIN
State
ZIP
I affirm under penalties prescribed by law this report, including any accompanying schedules and statements, has been prepared by me and to the best of my
knowledge and belief is a true, correct and complete report.
Signature of Preparer
Date
Signature of Preparer – Please sign after printing
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