Schedule Hi - Health Insurance Risk-Sharing Plan Assessments Credit - 2012 Page 2
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2012 Schedule HI
Page
Carryforward of Unused Credits
Line 3. Fill in the amount of HIRSP assessments
credit passed through from tax-option (S) corpora-
The HIRSP assessments credit is nonrefundable. Any
tions, partnerships, or LLCs treated as partnerships.
unused credit may be carried forward for 15 years.
The pass-through credit is shown on Schedule 5K-1
Caution: If any of the HIRSP assessments credit you
for shareholders of tax-option (S) corporations and
compute on Schedule HI cannot be offset against
Schedule 3K-1 for partners of partnerships or LLCs
your Wisconsin income or franchise tax liability, you
treated as partnerships.
may not claim the unused amount against premium
taxes. You may only carry forward HIRSP assess-
Line 4. For tax-option (S) corporations, partnerships,
ments credits computed on a Wisconsin franchise
and LLCs treated as partnerships, show the entire
or income tax return against Wisconsin franchise or
amount of credit on line 4 and prorate that amount
income taxes in future years.
among the shareholders, partners, or members on
Schedule 5K-1 or 3K-1.
If there is a reorganization of a corporation claim-
ing the HIRSP assessments credit, the limitations
Claiming the Credit: Enter the amount of credit
provided by the Internal Revenue Code section 383
computed on the appropriate line of Schedule CR. If
may apply to the carryover of any unused credit.
the claimant is a combined group member, enter the
credit amount on Form 4M instead of Schedule CR.
Specific Line Instructions
Required Attachments to Return
Line 1. For items (a) through (f), enter the informa-
tion for HIRSP assessments that you paid in the
File your completed Schedule HI with your Wisconsin
2012 taxable year covered by this return. Include
franchise or income tax return.
any assessments you received in a prior taxable
year that you paid in the 2012 taxable year covered
Additional Information
by this return.
For more information, you may:
For the amount in column (e), you may not have a
• E-mail your questions to corp@revenue.wi.gov
tax credit amount for each notice. In cases where
the HIRSP Authority issues two assessment notices
• Call (608) 266-2772 [TTY (608) 267-1049]
for one year, the credit for that entire year may be
• Send a FAX to (608) 267-0834
computed on the second notice. Since your taxable
year may be different than the basis HIRSP uses to
• Write to the A udit Bureau, Wisconsin Department of
issue the notices, you may need to allocate the credit
Revenue, Mail Stop 5-144, PO Box 8906, Madison
amount between the assessment notices.
WI 53708-8906.
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