Form M11 - Insurance Premium Tax Return For Property And Casualty Companies - 2017 Page 2
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6M11
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2017 Insurance Premium Tax Return for Property and Casualty Companies (continued)
A
B
State of Incorporation Basis
Minnesota Basis
Net taxable business (enter amounts from line 11) . . . . . . . . . . . . . . . . . . . . 1 5
15
*
%
%
16
Premium tax percentage rate* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 6
Premium tax liability (multiply line 15 by percentage on line 16) . . . . . . . . . 1 7
17
18
Fire insurance tax liability (from M11AR, line 12. Attach M11AR) . . . . . . . . . 1 8
Other taxes (itemize on a separate schedule) . . . . . . . . . . . . . . . . . . . . . . . . . 1 9
19
Total premium tax liability (add lines 17, 18 and 19) . . . . . . . . . . . . . . . . . . . 2 0
20
21
Licenses and fees (from M11B, line 10. Attach M11B) . . . . . . . . . . . . . . . . . . 2 1
Total taxes, licenses and fees (add lines 20 and 21) . . . . . . . . . . . . . . . . . . . . 2 2
22
23
Enter amount from line 22, Column A or B, whichever is greater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3
Total licenses and fees (from M11B, line 11. Attach M11B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 4
24
Subtract line 24 from line 23 (if zero or less, skip lines 26 and 27,
25
and enter this amount on line 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 5
26
Minnesota Guaranty Fund Association offset (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 6
Minnesota Joint Underwriting Association (JUA) assessment (see instructions) . . . . . . . . . . . . . . . . . . . 2 7
27
28
Tax before refundable credits . If line 25 is zero or less, enter the amount from line 25 .
If line 25 is positive, subtract any amounts on lines 26 and 27 from line 25.
(If result is less than zero, enter zero) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 8
29 Credit for historic structure rehabilitation
(must attach credit certificate) and enter NPS project number: . . . . . . . . . .
2 9
30 Tax liability (subtract line 29 from line 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 0
31
a Prior year’s overpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 a
b Estimated payment March 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 b
c Estimated payment June 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 c
d Estimated payment Sept. 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 d
e Estimated payment Dec. 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 e
Add lines 31a through 31e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
32 Tax due (or overpaid) (subtract line 31 from line 30) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2
Enter on line 12 on page 1.
*
Line 16 — Tax Rates for Minnesota Basis (check one)
1 percent for mutual property and casualty insurance companies with total assets of $5 million or less at the end of the calen-
dar year . Enter total assets at end of year:
$
1 .26 percent for mutual insurance companies that sell both property and casualty insurance that had total assets greater than
$5 million at the end of the calendar year, but less than $1 .6 billion on Dec . 31, 1989 .
2 percent for insurance companies not listed above .
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