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ANNUAL REPORT OF FIRE PREMIUMS TAX
                                  NYC
                                                                                                                                                                   DO NOT WRITE IN THIS SPACE - FOR OFFICIAL USE ONLY
 NEW YORK CITY DEPARTMENT OF FINANCE



                                      UPON FOREIGN AND ALIEN INSURERS
                                  FP
                    TM




 Finance




                                                                                                                                                                                               Calendar year___________
                                                                  FINAL RETURN - DATE BUSINESS ENDED: _________________________
                                         CHECK THE
                                                                                                                                                                    AMENDED RETURN
                                         APPLICABLE
                                                                  INITIAL RETURN - DATE BUSINESS BEGAN: _________________________
                                         BOXES
  M PRINT OR TYPE M




                                                  M
  Name

                                                                                                                                                                           EMPLOYER IDENTIFICATION NUMBER
  Address (number and street)


  City and State                                                                                          Zip Code



         SCHEDULE A                                Computation of Tax (See Instructions)
              Payment Pay amount shown on line 11 - Make check payable to: NYC Department of Finance
                                                                                                                                                                                                          Payment Enclosed
 A.

                                                                                                                                       COLUMN A                         COLUMN B*                         COLUMN C
   NOTE: Amount of New York City premiums to be reported shall be
         computed before any deductions for any agentsʼ or brokersʼ fees,                                                                  NET NYC                        PERCENTAGE                   TAXABLE PREMIUMS
         commissions or other expenses.                                                                                                                                                             (COLUMN A X COLUMN B)
                                                                                                                                          PREMIUMS                           TAXABLE

 1. Amount of FIRE premiums:
                                                                                                                                                                                100 %
    a. Direct - other than pool and syndicate ........................................................1a.
                                                                                                                                                                                100 %
      b. Pool or syndicate participation ....................................................................1b.
 2. Amount of AUTO premiums:
    a. AUTO physical damage premiums, fully covered (excluding collision)
                                                                                                                                                                                          %
       (1 ) PERSONAL ..........................................................................................2a. (1)

                                                                                                                                                                                          %
                                                                                                                          (2)
            (2)   COMMERCIAL........................................................................................2a.

      b. AUTO physical damage premiums with deductible clauses (excluding collision)
                                                                                                                                                                                          %
         (1) PERSONAL ...........................................................................................2b. (1)

                                                                                                                                                                                          %
                                                                                                                          (2)
            (2)   COMMERCIAL........................................................................................2b.

                                                                                                                                                                                          %
 3. Amount of premiums on HOME OWNERS insurance ........................................3.

                                                                                                                                                                                          %
 4. Amount of premiums on COMMERCIAL MULTIPLE PERIL insurance..............4.

                                                                                                                                                                                          %
 5. Amount of premiums on COMPREHENSIVE DWELLINGS...............................5.
 6. Amount of other reportable premiums in ANY TYPE POLICY
                                                                                                                                                                                          %
    (not included in 1, 2, 3, 4 and 5) .........................................................................6.

 7. TOTAL TAXABLE PREMIUMS (add lines 1 through 6, column C) .........................................................................................7.

 8. Total Tax due – 2% of line 7 .....................................................................................................................................................8.

 9. Interest (see instructions) .........................................................................................................................................................9.

10. Additional Charges (see instructions) .....................................................................................................................................10.

11. TOTAL REMITTANCE DUE – (line 8 plus lines 9 and 10). Enter payment amount on Line A, above .............................11.

                                           *Column B - Percentage of New York City premiums attributable to Fire Insurance
                                          Note: Entries must be made in all appropriate columns including percentage taxable.
                                                             CERTIFICATION OF AN ELECTED OFFICER OF THE CORPORATION
I hereby certify that this return, including any accompanying schedules or statements, has been examined by me and is, to the best of my knowledge and belief, true, correct and complete.
I authorize the Dept. of Finance to discuss this return with the preparer listed below. (see instructions) .......................................YES



                                                                                                                                                                                        •
                                                                                                                                                                                              Preparerʼs Social Security Number or PTIN
 SIGN
 HERE:
            Signature of officer                                              TITLE                                 TELEPHONE NUMBER                      Date



                                                                                                                                                                                        •
 PREPARERʼS                                                                                                                                                                                      Firmʼs Employer Identification Number
                                                                                                                                    Checkbox if Self-Employed
                   Preparerʼs signature                                                      DATE
        ©
 USE
 ONLY


                   Firmʼs name (or yours, if self-employed)                        Address                                                                Zip Code

To receive proper credit, you must enter                                       This return and all accompanying documents                                      Make remittance payable to the order of:
                                                                                                                                                                        NYC DEPARTMENT OF FINANCE.
your correct Employer Identification                                           must be postmarked by March 1 following
Number on your tax return and remittance.                                      the close of the preceding tax year.                                            Payment must be made in U.S. dollars, drawn on a U.S. bank

                                                                       MAILING INSTRUCTIONS ARE ON THE REVERSE SIDE
                                                                                                                                                                                                                            NYC-FP 2008
Form NYC-FP                                                                                                   Page 2
        LIST COMPLETE NAMES, PRINCIPAL BUSINESS ADDRESSES AND EMPLOYER IDENTIFICATION NUMBERS FOR ALL MEMBERS
                                 OF THIS GROUP. (ATTACH ADDITIONAL PAGES IF NECESSARY)

                                                                                  EMPLOYER
                                                                                                       TAX
              NAME                              ADDRESS                         IDENTIFICATION
                                                                                                       PAID
                                                                                   NUMBER

GROUP
NAME

MEMBER M


1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

                                           Mail report and remittance to:
                                           NYC DEPARTMENT OF FINANCE
                                           AUTOMATED TAX PROCESSING UNIT
                                           FIRE PREMIUMS SECTION
                                           59 MAIDEN LANE, 18TH FLOOR
                                           NEW YORK, NY 10038
INSTRUCTIONS - Form NYC-FP - Annual Report of Fire Premiums Tax Upon Foreign and Alien Insurers,                  page 1

G E N E R A L I N F O R M AT I O N                            WHEN AND WHERE TO FILE
                                                              The report and all accompanying documents, including
DEFINITIONS                                                   payment, must be filed and postmarked on or before
1. “Alien Insurer” Any insurer incorporated or organ-         March 1, covering the preceding tax year from January 1
   ized under the laws of any foreign nation, or of any       to December 31. Reports and remittances should be
   province or territory not included under the defini-       mailed to:
   tion of a foreign insurer.
                                                                      NYC Department of Finance
                                                                      Automated Tax Processing Unit
2. “Foreign Insurer” Any insurer, except a mutual
                                                                      Fire Premiums Section
   insurance company taxed under the provisions of
                                                                      59 Maiden Lane, 18th Floor
   Section 9105 of the Insurance Law, incorporated or
                                                                      New York, NY 10038
   organized under the laws of any state, as herein
   defined, other than this state.
                                                              PLACE OF BUSINESS TO BE REPORTED
3. “Fire insurance corporation, association or indi-          Any change in principal place of business or termination
   viduals” Any insurer, regardless of the name, desig-       of any office or place of business in New York City must
                                                              be reported within 15 days after the change or termina-
   nation or authority under which it purports to act,
                                                              tion.
   which insures property of any kind or nature against
   loss or damage by fire.
                                                              Preparer Authorization: If you want to allow the
4. “Loss or damage by fire” Loss or damage by fire,           Department of Finance to discuss your return with the
   lightning, smoke, or anything used to combat fire,         paid preparer who signed it, you must check the “yes”
   regardless of whether such risks or the premiums           box in the signature area of the return. This authorization
   therefore are stated or charged separately and apart       applies only to the individual whose signature appears in
   from any other risk or premium.                            the “Preparer’s Use Only” section of your return. It does
                                                              not apply to the firm, if any, shown in that section. By
5. “State” Any state of the United States and the             checking the “Yes” box, you are authorizing the
   District of Columbia.                                      Department of Finance to call the preparer to answer any
                                                              questions that may arise during the processing of your
REQUIREMENTS FOR FILING                                       return. Also, you are authorizing the preparer to:

                                                              •
Every foreign and alien insurer is required, pursuant to
the provisions of Title 11, Chapter 9 of the NYC
                                                                  Give the Department any information missing from
Administrative Code, to pay to the Department of
                                                                  your return,

                                                              •
Finance on or before March 1 following the close of the
previous tax year (January 1 to December 31) the amount           Call the Department for information about the pro-
of 2% of net New York City premiums (all New York                 cessing of your return or the status of your refund or
City premiums, less return premiums) received or writ-            payment(s), and

                                                              •
ten from January 1 to December 31 for any insurance
against loss or damage by fire on real or personal prop-          Respond to certain notices that you have shared
erty in the City of New York (including that portion of           with the preparer about math errors, offsets, and
                                                                  return preparation. The notices will not be sent to the
fire premiums in automobile and multiple peril policies
                                                                  preparer.
which insures against loss or damage by fire) and to file
with the Department of Finance, at the time of paying the
                                                              You are not authorizing the preparer to receive any
tax, a verified report setting forth the net New York City
                                                              refund check, bind you to anything (including any addi-
premiums upon which the tax is payable. If no premiums
                                                              tional tax liability), or otherwise represent you before the
were received during the tax year, a letter to that effect,
                                                              Department. The authorization cannot be revoked, how-
signed by an official of the insurer, is to be submitted.
                                                              ever, the authorization will automatically expire no later
Any insurer engaged solely in reinsurance is required to
                                                              than the due date (without regard to any extensions) for
submit an affidavit stating that its transactions are
                                                              filing next year's return. Failure to check the box will
restricted to reinsurance and that it has not issued any
                                                              be deemed a denial of authority.
direct policies in the City of New York.
INSTRUCTIONS - Form NYC-FP - Annual Report of Fire Premiums Tax Upon Foreign and Alien Insurers,                   page 2

SPECIFIC INSTRUCTIONS                                           c) If you fail to pay the tax shown on the return by the
                                                                prescribed filing date, add to the tax (less any payments
Schedule A - Computation of Tax                                 made or any credits claimed on the return) 1/2% for each
                                                                month or partial month the payment is late up to 25%,
LINES 1 THROUGH 6 - NET PREMIUMS/TAX-
                                                                unless the failure is due to reasonable cause.
ABLE PREMIUMS
1. Enter on line 1 through line 6, in column A, the New
                                                                d) The total of the additional charges in a) and c) may
   York City net premiums (all New York City premi-
                                                                not exceed 5% for any one month except as provided for
   ums, less return premiums) received or written from
                                                                in b).
   January 1 to December 31 in the year preceding the
   due date of the return for any insurance against loss
                                                                If you claim not to be liable for these additional charges,
   or damage on real or personal property in the City of
                                                                attach a statement to your return explaining the delay in
   New York, including any automobile and multiple
                                                                filing, payment or both.
   peril policies which insure against loss or damage.

                                                                LINE 11 - TOTAL REMITTANCE DUE
2. Enter on line 1 through line 6, column B, the per-
                                                                Enter on line 11, column C, the total of lines 8, 9 and 10,
   centages of the net New York City premiums attrib-
                                                                column C. Enter the amount of payment remitted with
   utable to fire insurance and to be applied to column
                                                                this return on line A, in the space provided. Payment
   A in order to arrive at the taxable premiums, line 1
                                                                must be made in U.S. dollars, drawn on a U.S. bank.
   through line 6, column C.
                                                                Make remittance payable to the order of:
LINE 7 - TOTAL TAXABLE PREMIUMS                                         NYC DEPARTMENT OF FINANCE
Enter on line 7, column C, the total taxable premiums
(the sum of line 1 through line 6, column C).                   NOTE: All books and records, schedules and working
                                                                papers used in the preparation of the return must be
LINE 8 - TOTAL TAX DUE                                          retained and made available for inspection upon demand
Enter on line 8, column C, the total tax due (2 % of line       by the Department of Finance. A notice “Records
7, column C).                                                   Required for Audit of Tax on Premiums on Policies of
                                                                Foreign and Alien Insurers” (Form FP-I) will be mailed
LINE 9 - INTEREST                                               upon request.
If the tax is not paid on or before the due date (deter-
mined without regard to any extension of time), interest        CUSTOMER ASSISTANCE
must be paid on the amount of the underpayment from             If you have a tax-related question or prioblem, contact
the due date to the date paid. For information as to the        Finance Customer Assistance at (212) 504-4036.
applicable rate of interest, call Customer Assistance at:
(212) 504-4036. Interest amounting to less than $1 need
not be paid.

LINE 10 - ADDITIONAL CHARGES/PENALTIES
a) If you fail to file a return when due, add to the tax
(less any payments made on or before the due date or any
credits claimed on the return) 5% for each month or
partial month the return is late, up to 25%, unless the fail-
ure is due to reasonable cause.

b) If the return is filed more than 60 days late, the min-
imum late filing penalty will not be less than the lesser
of a) $100 or b) 100% of the amount required to be
shown as tax due on the return (less any payments or
credits claimed).

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NYC-FP Annual Report of Fire Premiums Tax Upon Foreign and Alien Insurers

  • 1. ANNUAL REPORT OF FIRE PREMIUMS TAX NYC DO NOT WRITE IN THIS SPACE - FOR OFFICIAL USE ONLY NEW YORK CITY DEPARTMENT OF FINANCE UPON FOREIGN AND ALIEN INSURERS FP TM Finance Calendar year___________ FINAL RETURN - DATE BUSINESS ENDED: _________________________ CHECK THE AMENDED RETURN APPLICABLE INITIAL RETURN - DATE BUSINESS BEGAN: _________________________ BOXES M PRINT OR TYPE M M Name EMPLOYER IDENTIFICATION NUMBER Address (number and street) City and State Zip Code SCHEDULE A Computation of Tax (See Instructions) Payment Pay amount shown on line 11 - Make check payable to: NYC Department of Finance Payment Enclosed A. COLUMN A COLUMN B* COLUMN C NOTE: Amount of New York City premiums to be reported shall be computed before any deductions for any agentsʼ or brokersʼ fees, NET NYC PERCENTAGE TAXABLE PREMIUMS commissions or other expenses. (COLUMN A X COLUMN B) PREMIUMS TAXABLE 1. Amount of FIRE premiums: 100 % a. Direct - other than pool and syndicate ........................................................1a. 100 % b. Pool or syndicate participation ....................................................................1b. 2. Amount of AUTO premiums: a. AUTO physical damage premiums, fully covered (excluding collision) % (1 ) PERSONAL ..........................................................................................2a. (1) % (2) (2) COMMERCIAL........................................................................................2a. b. AUTO physical damage premiums with deductible clauses (excluding collision) % (1) PERSONAL ...........................................................................................2b. (1) % (2) (2) COMMERCIAL........................................................................................2b. % 3. Amount of premiums on HOME OWNERS insurance ........................................3. % 4. Amount of premiums on COMMERCIAL MULTIPLE PERIL insurance..............4. % 5. Amount of premiums on COMPREHENSIVE DWELLINGS...............................5. 6. Amount of other reportable premiums in ANY TYPE POLICY % (not included in 1, 2, 3, 4 and 5) .........................................................................6. 7. TOTAL TAXABLE PREMIUMS (add lines 1 through 6, column C) .........................................................................................7. 8. Total Tax due – 2% of line 7 .....................................................................................................................................................8. 9. Interest (see instructions) .........................................................................................................................................................9. 10. Additional Charges (see instructions) .....................................................................................................................................10. 11. TOTAL REMITTANCE DUE – (line 8 plus lines 9 and 10). Enter payment amount on Line A, above .............................11. *Column B - Percentage of New York City premiums attributable to Fire Insurance Note: Entries must be made in all appropriate columns including percentage taxable. CERTIFICATION OF AN ELECTED OFFICER OF THE CORPORATION I hereby certify that this return, including any accompanying schedules or statements, has been examined by me and is, to the best of my knowledge and belief, true, correct and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (see instructions) .......................................YES • Preparerʼs Social Security Number or PTIN SIGN HERE: Signature of officer TITLE TELEPHONE NUMBER Date • PREPARERʼS Firmʼs Employer Identification Number Checkbox if Self-Employed Preparerʼs signature DATE © USE ONLY Firmʼs name (or yours, if self-employed) Address Zip Code To receive proper credit, you must enter This return and all accompanying documents Make remittance payable to the order of: NYC DEPARTMENT OF FINANCE. your correct Employer Identification must be postmarked by March 1 following Number on your tax return and remittance. the close of the preceding tax year. Payment must be made in U.S. dollars, drawn on a U.S. bank MAILING INSTRUCTIONS ARE ON THE REVERSE SIDE NYC-FP 2008
  • 2. Form NYC-FP Page 2 LIST COMPLETE NAMES, PRINCIPAL BUSINESS ADDRESSES AND EMPLOYER IDENTIFICATION NUMBERS FOR ALL MEMBERS OF THIS GROUP. (ATTACH ADDITIONAL PAGES IF NECESSARY) EMPLOYER TAX NAME ADDRESS IDENTIFICATION PAID NUMBER GROUP NAME MEMBER M 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. Mail report and remittance to: NYC DEPARTMENT OF FINANCE AUTOMATED TAX PROCESSING UNIT FIRE PREMIUMS SECTION 59 MAIDEN LANE, 18TH FLOOR NEW YORK, NY 10038
  • 3. INSTRUCTIONS - Form NYC-FP - Annual Report of Fire Premiums Tax Upon Foreign and Alien Insurers, page 1 G E N E R A L I N F O R M AT I O N WHEN AND WHERE TO FILE The report and all accompanying documents, including DEFINITIONS payment, must be filed and postmarked on or before 1. “Alien Insurer” Any insurer incorporated or organ- March 1, covering the preceding tax year from January 1 ized under the laws of any foreign nation, or of any to December 31. Reports and remittances should be province or territory not included under the defini- mailed to: tion of a foreign insurer. NYC Department of Finance Automated Tax Processing Unit 2. “Foreign Insurer” Any insurer, except a mutual Fire Premiums Section insurance company taxed under the provisions of 59 Maiden Lane, 18th Floor Section 9105 of the Insurance Law, incorporated or New York, NY 10038 organized under the laws of any state, as herein defined, other than this state. PLACE OF BUSINESS TO BE REPORTED 3. “Fire insurance corporation, association or indi- Any change in principal place of business or termination viduals” Any insurer, regardless of the name, desig- of any office or place of business in New York City must be reported within 15 days after the change or termina- nation or authority under which it purports to act, tion. which insures property of any kind or nature against loss or damage by fire. Preparer Authorization: If you want to allow the 4. “Loss or damage by fire” Loss or damage by fire, Department of Finance to discuss your return with the lightning, smoke, or anything used to combat fire, paid preparer who signed it, you must check the “yes” regardless of whether such risks or the premiums box in the signature area of the return. This authorization therefore are stated or charged separately and apart applies only to the individual whose signature appears in from any other risk or premium. the “Preparer’s Use Only” section of your return. It does not apply to the firm, if any, shown in that section. By 5. “State” Any state of the United States and the checking the “Yes” box, you are authorizing the District of Columbia. Department of Finance to call the preparer to answer any questions that may arise during the processing of your REQUIREMENTS FOR FILING return. Also, you are authorizing the preparer to: • Every foreign and alien insurer is required, pursuant to the provisions of Title 11, Chapter 9 of the NYC Give the Department any information missing from Administrative Code, to pay to the Department of your return, • Finance on or before March 1 following the close of the previous tax year (January 1 to December 31) the amount Call the Department for information about the pro- of 2% of net New York City premiums (all New York cessing of your return or the status of your refund or City premiums, less return premiums) received or writ- payment(s), and • ten from January 1 to December 31 for any insurance against loss or damage by fire on real or personal prop- Respond to certain notices that you have shared erty in the City of New York (including that portion of with the preparer about math errors, offsets, and return preparation. The notices will not be sent to the fire premiums in automobile and multiple peril policies preparer. which insures against loss or damage by fire) and to file with the Department of Finance, at the time of paying the You are not authorizing the preparer to receive any tax, a verified report setting forth the net New York City refund check, bind you to anything (including any addi- premiums upon which the tax is payable. If no premiums tional tax liability), or otherwise represent you before the were received during the tax year, a letter to that effect, Department. The authorization cannot be revoked, how- signed by an official of the insurer, is to be submitted. ever, the authorization will automatically expire no later Any insurer engaged solely in reinsurance is required to than the due date (without regard to any extensions) for submit an affidavit stating that its transactions are filing next year's return. Failure to check the box will restricted to reinsurance and that it has not issued any be deemed a denial of authority. direct policies in the City of New York.
  • 4. INSTRUCTIONS - Form NYC-FP - Annual Report of Fire Premiums Tax Upon Foreign and Alien Insurers, page 2 SPECIFIC INSTRUCTIONS c) If you fail to pay the tax shown on the return by the prescribed filing date, add to the tax (less any payments Schedule A - Computation of Tax made or any credits claimed on the return) 1/2% for each month or partial month the payment is late up to 25%, LINES 1 THROUGH 6 - NET PREMIUMS/TAX- unless the failure is due to reasonable cause. ABLE PREMIUMS 1. Enter on line 1 through line 6, in column A, the New d) The total of the additional charges in a) and c) may York City net premiums (all New York City premi- not exceed 5% for any one month except as provided for ums, less return premiums) received or written from in b). January 1 to December 31 in the year preceding the due date of the return for any insurance against loss If you claim not to be liable for these additional charges, or damage on real or personal property in the City of attach a statement to your return explaining the delay in New York, including any automobile and multiple filing, payment or both. peril policies which insure against loss or damage. LINE 11 - TOTAL REMITTANCE DUE 2. Enter on line 1 through line 6, column B, the per- Enter on line 11, column C, the total of lines 8, 9 and 10, centages of the net New York City premiums attrib- column C. Enter the amount of payment remitted with utable to fire insurance and to be applied to column this return on line A, in the space provided. Payment A in order to arrive at the taxable premiums, line 1 must be made in U.S. dollars, drawn on a U.S. bank. through line 6, column C. Make remittance payable to the order of: LINE 7 - TOTAL TAXABLE PREMIUMS NYC DEPARTMENT OF FINANCE Enter on line 7, column C, the total taxable premiums (the sum of line 1 through line 6, column C). NOTE: All books and records, schedules and working papers used in the preparation of the return must be LINE 8 - TOTAL TAX DUE retained and made available for inspection upon demand Enter on line 8, column C, the total tax due (2 % of line by the Department of Finance. A notice “Records 7, column C). Required for Audit of Tax on Premiums on Policies of Foreign and Alien Insurers” (Form FP-I) will be mailed LINE 9 - INTEREST upon request. If the tax is not paid on or before the due date (deter- mined without regard to any extension of time), interest CUSTOMER ASSISTANCE must be paid on the amount of the underpayment from If you have a tax-related question or prioblem, contact the due date to the date paid. For information as to the Finance Customer Assistance at (212) 504-4036. applicable rate of interest, call Customer Assistance at: (212) 504-4036. Interest amounting to less than $1 need not be paid. LINE 10 - ADDITIONAL CHARGES/PENALTIES a) If you fail to file a return when due, add to the tax (less any payments made on or before the due date or any credits claimed on the return) 5% for each month or partial month the return is late, up to 25%, unless the fail- ure is due to reasonable cause. b) If the return is filed more than 60 days late, the min- imum late filing penalty will not be less than the lesser of a) $100 or b) 100% of the amount required to be shown as tax due on the return (less any payments or credits claimed).