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Should the Whole Dollar Method be Used?

Line 11 — Economic Opportunity Area Credit. Enter the amount

of Economic Opportunity Area credit claimed this year from Schedule

Yes. All amounts must be rounded off to the nearest dollar.

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

Federal Audit

more information, contact the Massachusetts Office of Business De-

If your company has undergone a federal audit for some prior year,

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

you must report any changes on Massachusetts Form CA-6, Applica-

Line 12 — Full Employment Program Credit. A qualified employer

tion for Abatement/Amended Return, within three months after the

participarting in the Full Employment Program may claim a credit of

final determination of the correct taxable income by the IRS. Other-

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

wise, you will be subject to a penalty. Answering “yes” to this question

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

does not relieve the company of this filing obligation.

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

Preferred Provider Deduction

more information, contact the Department of Transitional Assistance,

An organization that has entered into a preferred provider arrangement

600 Washington Street, Boston, MA 02111.

and has been approved by the Commissioner of Insurance may de-

Line 14. Any corporation that wishes to contribute any amount to the

duct those premiums relating to preferred provider arrangements if

Natural Heritage and Endangered Species Fund may do so on his

they have been included in line 8 of Part I of this return and reported

form. This amount is added to the excise due. It increases the amount

on Form 176-I, Preferred Provider Gross Revenue Excise Return.

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

These premiums are deducted on Part I, line 10.

The Natural Heritage and Endangered Species Fund is administered

Computation of Excise

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

Line 1. Enter the amount of life premiums subject to tax in Massachu-

forcement to provide for conservation programs for rare, endangered

setts from Part I, line 7. If amount is negative, enter zero.

and nongame wildlife and plants in the Commonwealth.

Lines 2 and 5. Use the back of Form 63-20-23 to calculate your ex-

Lines 20 through 22. If line 19 is larger than line 15, enter the amount

cise using the same method and rate used by the state in which you

overpaid in line 20.

are incorporated and would be imposed on a like Massachusetts in-

surance company, or its agents, if doing business to the same extent.

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

If the computation in the state of your incorporation is in every respect

taxes by entering in line 21 the amount to be credited to 2002 esti-

the same as your Massachusetts computation, a statement to that ef-

mated tax payments. Enter the amount to be refunded in line 22.

fect should be made. Retaliatory tax provisions are provided under

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

MGL Chapter 63, Section 24A.

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

Line 4. Enter the amount of total net direct accident and health premi-

Line 23. If line 15 is larger than line 19, enter the balance due in line

ums subject to tax in Massachusetts from Part I, line 12. If the amount

22. Payment in full is due on or before March 15, 2002.

is negative, enter zero.

Line 24. Any company that has an underpayment of estimated tax will

Line 7 — Recapture. If the corporation is required to recapture any

incur a penalty on the underpayment for the period of the underpay-

amount of previously claimed EOA Credit, complete Schedule H-2

ment. Attach a copy of Form M-2220. For more information, refer to

and enter the result in line 7 of the return. Current year credits can

the section, “When Are Estimated Tax Payments Required?”

then be used to offset the total excise due which will include the re-

capture amount.

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

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

Line 9 — Initiative Credit. A company shall be allowed a credit

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

against the premium tax equal to 1.5 percent of such company’s total

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

capital contribution in excess of their full proportionate share which

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

shall mean an investment in the Massachusetts Life Insurance Com-

pany Community Investment Initiative.

Line 25. Any company that fails to pay its tax when due will be sub-

ject to interest on the unpaid balance. For more information, refer to

This credit is effective for tax years in which the aggregate cumulative

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

investment in the Massachusetts Life Insurance Community Invest-

ment Initiative reaches 100 million or the tax year 2004, whichever

Line 26. Enter the total payment due. Checks for this amount should

is later.

be made payable to the Commonwealth of Massachusetts. Checks

should have the company’s federal identification number written in the

Line 10 — Credit for Member Insurers of the Massachusetts Life

lower left corner.

and Health Insurance Guaranty Association. Enter 10% of the

assessment for each of five years following the year in which the as-

Signature

sessment was paid. If the sum of offsets exceeds $3,000,000, the

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

excess may be carried forward and may be used in a year in which

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

the $3,000,000 is not exceeded. If the total offsets exceed $3,000,000

appropriate corporate officer, check the box in the signature section

in a year, the Department of Revenue will assess each member with

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

an additional tax equal to the amount of the offset which exceeds

form should be mailed to:

$3,000,000 of such members pro rata share. If the total offsets do not

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

Massachusetts Department of Revenue

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

PO Box 7052

each member and issue a refund to each member.

Boston, MA 02204

Form 63-20-23 - Premium Excise Return For Foreign Life Insurance Companies On Life, Accident And Health Business - 2001 Page 4

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