Form 63-22 - Premium Excise Return For Domestic Insurance Companies

exceed $3,000,000 in a year, the Department of Revenue will calculate

An overpayment of tax cannot be applied as a credit to the tax of an-

each members’ pro rata share to determine the amount of refund due

other account of this company or to the tax of another company.

each member and issue a refund to each member.

Line 22 — Balance Due. If line 15 is larger than line 19, enter the bal-

Line 10 — Economic Opportunity Area Credit. Enter the amount of

ance due in line 23. Full payment is due on or before March 15, 2002.

Economic Opportunity Area credit claimed this year from Schedule

Line 24 — Penalties. Any company that has an underpayment of

EOA, line 9. Attach a completed Schedule EOA to this return. For more

estimated tax will incur a penalty on the underpayment for the period

information, contact the Massachusetts Office of Business Develop-

of the underpayment. Attach a copy of Form M-2220. For more in-

ment at One Ashburton Place, Room 2101, Boston, MA 02108.

formation, refer to the section, “When Are Estimated Tax Payments

Line 11 — Full Employment Program Credit. A qualified employer

Required?”

participarting in the Full Employment Program may claim a credit of

Any company that fails to file a timely return will be subject to a late

$100 per month of eligible employment per employee. The maximum

filing penalty of 1% per month, or fraction thereof, and a late payment

amount of credit that may be applied in all taxable years with respect

penalty of ¹ ₂% per month, or fraction thereof, on the amount required

to each employee is $1,200. Attach Schedule FEC to this return. For

to be shown as the tax due on the return. For more information, refer

more information, contact the Department of Transitional Assistance,

to the section, “What Are the Penalties for Late Returns?”

600 Washington Street, Boston, MA 02111.

Line 25 — Interest. Any company which fails to pay its excise when

Line 14 — Voluntary Contribution for Endangered Wildlife Con-

due will be subject to interest charges on the unpaid balance. For

servation. Any corporation that wishes to contribute any amount to

more information, refer to the section, “What Are the Penalties for

the Natural Heritage and Endangered Species Fund may do so. This

Late Returns?”

amount is added to the excise due. It increases the amount of the

corporation’s payment or reduces the amount of its refund.

Line 26 — Payment Due. Enter the total payment due. Checks for

this amount should be made payable to the Commonwealth of Mass-

The Natural Heritage and Endangered Species Fund is administered

achusetts. Checks should have the company’s federal identification

by the Department of Fisheries, Wildlife and Environment Law En-

number written in the lower left corner.

forcement to provide for conservation programs for rare, endangered

and nongame wildlife and plants in the Commonwealth.

Signature

Lines 20 through 22 — Overpayments and Refunds. If line 19 is

When the form is complete, it must be signed by the treasurer or as-

sistant treasurer. If you are signing as an authorized delegate of the

larger than line 15, enter the amount overpaid in line 20.

appropriate corporate officer, check the box in the signature section

The overpayment may be applied in part or in full to 2002 estimated

and attach a Massachusetts Form M-2848, Power of Attorney. This

taxes by entering the amount of the overpayment to be credited to

form should be mailed to:

2002 estimated tax payments in line 21. Enter the amount to be re-

funded in line 22.

Massachusetts Department of Revenue

PO Box 7052

Boston, MA 02204

Form 63-22 - Premium Excise Return For Domestic Insurance Companies - 2001 Page 5

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