Form M11l - Insurance Premium Tax Return For Life And Health Companies - 2017 Page 4
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52017 Form M11L Instructions (continued)
Completing Form M11L
If the reported premiums are different from
ers who are eligible for the Federal Historic
the premiums on the state page or Schedule
Rehabilitation Credit for improving a certi-
Check Boxes
T, attach a schedule reconciling the differ-
fied historic structure located in Minnesota.
At the top of the form, check if the return
ence.
The credit is equal to 100 percent of the
is:
federal credit, and it may be transferred
Lines 5 and 6
or assigned to others, including insurance
• an Amended Return: Check only if you
Dividends
companies.
are amending a previously filed return
Enter the dividends to be included in the
for the same period. Include all original
To qualify for the Minnesota credit, the
gross taxable business. If dividends listed
and corrected premiums on the amended
project developer must apply for approval
differ from your annual statement, attach a
return.
from the State Historic Preservation Office
statement explaining the differences.
(SHPO) of the Minnesota Historical Society
Columns A and B
before any rehabilitation of the structure
Line 7
All domestic, foreign and alien insur-
begins. For eligibility requirements and
Other Additions
ers must complete Column B (Minnesota
information on how to apply for approval,
Attach a separate schedule itemizing the ad-
basis).
go to the SHPO website at
ditions and amounts included on this line.
shpo.
Foreign and alien insurers (except Arizona,
Lines 10 through 15
Hawaii, Massachusetts New York, and
Once the approved project has been com-
Rhode Island domiciled companies) must
Dividends
pleted and placed into service, the SHPO
also complete Column A (for purposes of
Enter dividends only if returned to the in-
will issue a credit certificate. From the cred-
applying Minnesota retaliatory laws) and
sured person or entity paying the premium.
it certificate you received from the SHPO,
Schedule M11B.
enter the five‑digit NPS project number and
Lines 25 and 28
the amount of your credit on line 39. You
Note: All premiums, deductions and result-
Premium Tax Percentage Rate
must include the credit certificate when you
ing taxes listed in Column A must be in
If premiums are taxed at more than one
file your Form M11L.
accordance with the laws of the state or
rate, enclose a schedule showing rates and
country of incorporation as they would
premiums. Life insurance premiums are
Lines 41a Through 41e
apply to a Minnesota insurer licensed and
taxed at 1.5 percent and accident and health
Estimated Tax Payments
doing business in that state or country. If
premiums are taxed at 2 percent.
If any line contains more than one payment,
the taxing authority of the state or country
you must attach a schedule.
of incorporation requires a supplemental
Line 37
schedule to support tax computations, the
Guaranty Fund Assessment
If payments are included from a merged
same type of schedule (applying to business
Twenty percent of assessments (less any
company, attach a schedule listing the
in Minnesota) must be attached to Minne-
refunds) made and paid to the Minnesota
merged company name, NAIC number,
sota Form M11L.
Life and Health Guaranty Association or
payment amounts and payment dates.
the Minnesota Insurance Guaranty As-
In Column B (Minnesota basis), include
Line 43a
sociation are allowable offsets against the
direct premiums; stop-loss premiums; as-
Additional Charge for Underpaying
tax liability for the five years following the
sessments; deposits; policy, membership
Estimated Tax
payment of the assessment. Contact our
and survey fees; and dues, dividends and
If you did not pay the correct amount of
office if you have questions about carrying
interest applied to reduce current premi-
estimated tax by the due dates and your tax
forward credits.
ums, pay renewal premiums, shorten the
liability on line 40 is more than $500, you
premium paying period or provide extended
If assessments are more than your tax liabil-
may have to pay an additional charge for
and paid-up additional insurance.
ity (positive amount on line 36), use only
underpaying. Complete the worksheet on
the amount necessary to reduce your tax
Exclude employer contributions credited
page 3 to determine the amount to enter on
liability to zero; the remaining amount may
for the insurer’s employees’ and agents’
line 43a.
be deducted in future tax years.
life, accident and health insurance plans;
Line 43b
and all return premiums on policies not
If you receive a refund for an assessment
taken, except cash surrender values paid
Penalty
from the association, the refund must
Late Payment. If you file on time but do
upon the cancellation and surrender of poli-
be subtracted from the paid assessment
not pay all the tax due by the due date, a
cies or certificates of life insurance. If these
amount. If a refund is more than the assess-
late payment penalty is due. The penalty
premiums were included on line 8, you
ment, the excess must be paid to Minnesota.
is 5 percent of the unpaid tax for any part
may deduct them on line 15; if they were
Line 38
of the first 30 days the payment is late, and
included on line 18, you may deduct them
5 percent for each additional 30-day period,
on line 19.
Tax Before Refundable Credits
The amount on line 38 can only be negative
up to a maximum of 15 percent.
due to return premiums. It cannot be nega-
Line instructions
Late Filing. Add a late filing penalty to
tive due to guaranty fund association offsets
Round amounts to the nearest dollar.
the late payment penalty if your return is
(see instructions for line 37).
Decrease any amount less than 50 cents
not filed by the due date. The penalty is
and increase any amount that is 50 cents or
5 percent of the unpaid tax. When added
Line 39
more to the next higher dollar.
Historic Structure Rehabilitation Credit
2
A refundable credit is available to taxpay-
Continued
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