Fillable F1120pm3 Accessible 2019 Schedule M-3 (Form 1120-PC)

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F1120pm3 Accessible 2019 Schedule M-3 (Form 1120-PC)

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SCHEDULE M-3
(Form 1120-PC)
Department of the Treasury
Internal Revenue Service
Net Income (Loss) Reconciliation for U.S. Property and Casualty
Insurance Companies With Total Assets of $10 Million or More
▶
Attach to Form 1120-PC.
▶
Go to www.irs.gov/Form1120PC for instructions and the latest information.
OMB No. 1545-0123
2019
Check applicable box(es).
(1)
Non-consolidated return
(2)
Consolidated return (Form 1120-PC only)
(3)
Mixed 1120/L/PC group
(4)
Dormant subsidiaries schedule attached
Name of corporation (common parent, if consolidated return) Employer identification number
Part I Financial Information and Net Income (Loss) Reconciliation (see instructions)
1 a Did the corporation file SEC Form 10-K for its income statement period ending with or within this tax year?
Yes. Skip lines 1b and 1c and complete lines 2a through 11 with respect to that SEC Form 10-K.
No. Go to line 1b. See instructions if multiple non-tax-basis income statements are prepared.
b Did the corporation prepare a certified audited non-tax-basis income statement for that period?
Yes. Skip line 1c and complete lines 2a through 11 with respect to that income statement.
No. Go to line 1c.
c Did the corporation prepare a non-tax-basis income statement for that period?
Yes. Complete lines 2a through 11 with respect to that income statement.
No. Skip lines 2a through 3c and enter the corporation’s net income (loss) per its books and records on line 4a.
2 a Enter the income statement period:
Beginning Ending
b Has the corporation’s income statement been restated for the income statement period on line 2a?
Yes. (If “Yes,” attach an explanation and the amount of each item restated.)
No.
c
Has the corporation’s income statement been restated for any of the five income statement periods preceding the period on line 2a?
Yes. (If “Yes,” attach an explanation and the amount of each item restated.)
No.
3 a Is any of the corporation’s voting common stock publicly traded?
Yes.
No. If “No,” go to line 4a.
b
Enter the symbol of the corporation’s primary U.S. publicly traded voting common
stock . . . . . . . . . . . . . . . . . . . . . . . . . .
c
Enter the nine-digit CUSIP number of the corporation’s primary publicly traded voting
common stock . . . . . . . . . . . . . . . . . . . . . . .
4 a Worldwide consolidated net income (loss) from income statement source identified in Part I, line 1 . 4a
b Indicate accounting standard used for line 4a (see instructions).
(1)
GAAP
(2)
IFRS
(3)
Statutory
(4)
Other (specify)
5 a Net income from nonincludible foreign entities (attach statement) . . . . . . . . . . . . 5a (
)
b Net loss from nonincludible foreign entities (attach statement and enter as a positive amount) . . . 5b
6 a Net income from nonincludible U.S. entities (attach statement) . . . . . . . . . . . . . 6a
(
)
b Net loss from nonincludible U.S. entities (attach statement and enter as a positive amount) . . . . 6b
7 a Net income (loss) of other includible foreign disregarded entities (attach statement) . . . . . . 7a
b Net income (loss) of other includible U.S. disregarded entities (attach statement) . . . . . . . 7b
c Net income (loss) of other includible corporations (attach statement) . . . . . . . . . . . 7c
8
Adjustment to eliminations of transactions between includible entities and nonincludible entities
(attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
9 Adjustment to reconcile income statement period to tax year (attach statement) . . . . . . . 9
10a Intercompany dividend adjustments to reconcile to line 11 (attach statement) . . . . . . . . 10a
b Other statutory accounting adjustments to reconcile to line 11 (attach statement) . . . . . . . 10b
c Other adjustments to reconcile to amount on line 11 (attach statement) . . . . . . . . . . 10c
11
Net income (loss) per income statement of includible corporations. Combine lines 4a through 10c
11
Note: Part I, line 11, must equal the amount on Part II, line 30, column (a) and on Schedule M-2, line 2.
12
Enter the total amount (not just the corporation’s share) of the assets and liabilities of all entities included or removed on the following lines.
Total Assets Total Liabilities
a Included on Part I, line 4 . . . . .
▶
b Removed on Part I, line 5 . . . .
▶
c Removed on Part I, line 6 . . . .
▶
d Included on Part I, line 7 . . . . .
▶
For Paperwork Reduction Act Notice, see the Instructions for Form 1120-PC.
Cat. No. 39664A Schedule M-3 (Form 1120-PC) 2019
Schedule M-3 (Form 1120-PC) 2019
Page 2
Name of corporation (common parent, if consolidated return) Employer identification number
Check applicable box(es).
(1)
Consolidated group
(2)
Parent corp.
(3)
Consolidated eliminations
(4)
Subsidiary corp.
(5)
Mixed 1120/L/PC group
Check if a sub-consolidated:
(6)
1120-PC group
(7)
1120-PC eliminations
Name of subsidiary (if consolidated return) Employer identification number
Part II
Reconciliation of Net Income (Loss) per Income Statement of Includible Corporations With Taxable
Income per Return (see instructions)
Income (Loss) Items
(Attach
statements for lines 1 through 11)
(a)
Income (Loss) per
Income Statement
(b)
Temporary
Difference
(c)
Permanent
Difference
(d)
Income (Loss)
per Tax Return
1 Income (loss) from equity method foreign corporations
2 Gross foreign dividends not previously taxed . . .
3 Subpart F, QEF, and similar income inclusions . .
4 Gross-up for foreign taxes deemed paid . . . .
5 Gross foreign distributions previously taxed . . .
6 Income (loss) from equity method U.S. corporations .
7 U.S. dividends not eliminated in tax consolidation .
8 Minority interest for includible corporations . . . .
9 Income (loss) from U.S. partnerships . . . . . .
10 Income (loss) from foreign partnerships . . . . .
11 Income (loss) from other pass-through entities . .
12 Items relating to reportable transactions (attach
statement) . . . . . . . . . . . . . .
13 Interest income (attach Form 8916-A) . . . . .
14 Hedging transactions . . . . . . . . . . .
15 Mark-to-market income (loss) . . . . . . . .
16 Premium income (attach statement) . . . . . .
17 Sale versus lease (for sellers and/or lessors) . . .
18 Section 481(a) adjustments . . . . . . . . .
19 Reserved for future use . . . . . . . . . .
20 Income recognition from long-term contracts . . .
21 Original issue discount and other imputed interest .
22 Reserved for future use . . . . . . . . . .
23a
Income statement gain/loss on sale, exchange,
abandonment, worthlessness, or other disposition of
assets other than pass-through entities . . . . .
b Gross capital gains from Schedule D, excluding
amounts from pass-through entities . . . . . .
c
Gross capital losses from Schedule D, excluding
amounts from pass-through entities, abandonment
losses, and worthless stock losses . . . . . .
d
Net gain/loss reported on Form 4797, line 17,
excluding amounts from pass-through entities,
abandonment losses, and worthless stock losses .
e Abandonment losses . . . . . . . . . . .
f Worthless stock losses (attach statement) . . . .
g Other gain/loss on disposition of assets . . . . .
24 Capital loss limitation and carryforward used . . .
25
Other income (loss) items with differences (attach statement)
26
Total income (loss) items. Combine lines 1 through 25
27 Total expense/deduction items (from Part III, line 40)
28 Other items with no differences . . . . . . .
29a Mixed groups, see instructions. All others, combine
lines 26 through 28 . . . . . . . . . . .
b 1120 subgroup reconciliation totals . . . . . .
c Life insurance subgroup reconciliation totals . . .
30 Reconciliation totals. Combine lines 29a through 29c
Note: Line 30, column (a), must equal the amount on Part I, line 11, and column (d) must equal Form 1120-PC, Schedule A, line 35.
Schedule M-3 (Form 1120-PC) 2019
Schedule M-3 (Form 1120-PC) 2019
Page 3
Name of corporation (common parent, if consolidated return) Employer identification number
Check applicable box(es).
(1)
Consolidated group
(2)
Parent corp.
(3)
Consolidated eliminations
(4)
Subsidiary corp.
(5)
Mixed 1120/L/PC group
Check if a sub-consolidated:
(6)
1120-PC group
(7)
1120-PC eliminations
Name of subsidiary (if consolidated return) Employer identification number
Part III
Reconciliation of Net Income (Loss) per Income Statement of Includible Corporations With Taxable
Income per Return—Expense/Deduction Items (see instructions)
Expense/Deduction Items
(a)
Expense per
Income Statement
(b)
Temporary
Difference
(c)
Permanent
Difference
(d)
Deduction per
Tax Return
1 U.S. current income tax expense . . . . . . .
2 U.S. deferred income tax expense . . . . . .
3 State and local current income tax expense . . .
4 State and local deferred income tax expense . . .
5 Foreign current income tax expense (other than
foreign withholding taxes) . . . . . . . . .
6 Foreign deferred income tax expense . . . . .
7 Foreign withholding taxes . . . . . . . . .
8 Stock option expense . . . . . . . . . . .
9 Other equity-based compensation . . . . . . .
10 Meals and entertainment . . . . . . . . . .
11 Fines and penalties . . . . . . . . . . .
12 Judgments, damages, awards, and similar costs . .
13 Parachute payments . . . . . . . . . . .
14 Compensation with section 162(m) limitation . . .
15 Pension and profit-sharing . . . . . . . . .
16 Other post-retirement benefits . . . . . . . .
17 Deferred compensation . . . . . . . . . .
18 Charitable contribution of cash and tangible property
19 Charitable contribution of intangible property . . .
20 Charitable contribution limitation/carryforward . . .
21 Write-off of premium receivables . . . . . . .
22 Guarantee fund assessments . . . . . . . .
23 Current year acquisition or reorganization investment
banking fees . . . . . . . . . . . . . .
24 Current year acquisition or reorganization legal and
accounting fees . . . . . . . . . . . . .
25 Current year acquisition/reorganization other costs .
26
Amortization of acquisition, reorganization, and start-up costs
27 Amortization/impairment of goodwill, insurance in
force, and ceding commissions . . . . . . .
28 Other amortization or impairment write-offs . . . .
29
Discounting of unpaid losses (section 846) (attach statement)
30 Reduction of loss deduction (section 832(b)(5)(B)) .
31 Depreciation . . . . . . . . . . . . . .
32 Bad debt expense and/or agency balances written off
33 Reserved for future use . . . . . . . . . .
34 Corporate-owned life insurance premiums . . . .
35 Purchase versus lease (for purchasers and/or lessees)
36 Interest expense (attach Form 8916-A) . . . . .
37 Research and development costs . . . . . . .
38 Section 118 exclusion (attach statement) . . . .
39
Other expense/deduction items with differences
(attach statement) . . . . . . . . . . . .
40
Total expense/deduction items. Combine lines 1
through 39. Enter here and on Part II, line 27,
reporting positive amounts as negative and negative
amounts as positive . . . . . . . . . . .
Schedule M-3 (Form 1120-PC) 2019
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F1120pm3 Accessible 2019 Schedule M-3 (Form 1120-PC)

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Completed 22 June 2020

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