New York Captive Insurance Company Franchise Tax Return

Captive Insurance Company Franchise Tax Return
Form CT-33-C Captive Insurance Company Franchise Tax Return Tax Year 2023
CT-33-C

Department of Taxation and Finance

Captive Insurance Company
Franchise Tax Return
Tax Law – Article 33

All filers must enter tax period:
	

beginning

Amended return

Employer identification number (EIN)	

File number	

(	

		

ending

Business telephone number	

If you claim an
overpayment, mark
an X in the box

)

Legal name of corporation				

Trade name/DBA

Mailing address 				

State or country of incorporation

Care of (c/o)
Number and street or PO Box				

City	

U.S. state/Canadian province	

NAICS business code number (from NYS Pub 910)	

NYS principal business activity

ZIP/Postal code	

Date of incorporation	

Country (if not United States)

For office use only

If you need to update your address or phone information
for corporation tax, or other tax types, you can do so
	
online. See Business information in
	
Form CT-1.

Federal return was filed on (mark an X in one):	 1120-L	

1120-PC	

Consolidated	

	 A.	 Pay amount shown on line 19. Make payable to: New York State Corporation Tax	
		 Attach your payment here. Detach all check stubs. (See instructions for details.) 	

Computation of tax (see instructions)

Foreign corporations: date began business in NYS

Other:		

A

Tax on New York State gross direct premiums (see instr.)
	1	
First $20,000,000 of gross direct premiums....................	
×	0.004	
1
	 2	 $20,000,001-$40,000,000 of gross direct premiums ......	
×	0.003	
2
	 3	 $40,000,001-$60,000,000 of gross direct premiums ......	
×	0.002	
3
	 4	 Excess of $60,000,000 of gross direct premiums............	
×	0.00075	
4
Tax on New York State reinsurance premiums (see instr.)
	5	
First $20,000,000 of reinsurance premiums....................	
×	0.00225	
5
	 6	 $20,000,001-$40,000,000 of reinsurance premiums ......	
×	0.0015	
6
	 7	 $40,000,001-$60,000,000 of reinsurance premiums ......	
×	0.0005	
7
	 8	 Excess of $60,000,000 of reinsurance premiums............	
×	0.00025	
8	
Computation of tax
	9	
Tax due based upon premiums (add lines 1 through 8) ...................................................................... 	
9
	10	Minimum tax.......................................................................................................................................	 10	
	 11	 Tax due (enter the greater of line 9 or 10) ............................................................................................. 	 11
	12a
	12b
	13
	14	Total prepayments from line 27........................................................................................................ 	 14
	15a	 Balance (see instructions) .................................................................................................................. 	 15a
	15b	 Additional amount (see instructions) .................................................................................................. 	 15b
	15c	 Total before penalties and interest (see instructions) ......................................................................... 	 15c
	 16	 Estimated tax penalty (see instructions; mark an X in the box if Form CT-222 is attached) 	
............... 	16
	 17	 Interest on late payment (see instructions) ........................................................................................ 	 17
	18	Late filing and late payment penalties (see instructions) .................................................................... 	 18
	 19	 Balance due (add lines 15c through 18 and enter here; enter the payment amount on line A above) .......... 	 19
	20a	 Overpayment (if line 11 is less than line 14, subtract line 11 from line 14) ............................................... 	 20a
	20b	 Amount of overpayment previously credited to 2024 MFI (see instructions) ...................................... 	 20b
	20c	 Balance of overpayment available (see instructions) ......................................................................... 	 20c
	21	Amount of overpayment to be credited to next period..................................................................... 	 21
	22	Refund of overpayment (subtract line 21 from line 20c) ....................................................................... 	 22
431001230094

Payment
enclosed
			

5,000	00

Page 2 of 2 CT-33-C (2023)

Composition of prepayments on line 14 (see instructions)
	

	 23	 Mandatory first installment from Form CT-300 (see instructions)................................... 	 23	

Date paid 	

Amount

	24a	 Second installment from Form CT-400........................................................................ 	 24a
	24b	 Third installment from Form CT-400............................................................................ 	 24b
	24c	 Fourth installment from Form CT-400.......................................................................... 	 24c
	25	Payment with extension request (from Form CT-5, line 5) .............................................. 	 25
	26	Overpayment credited from prior years (see instructions) ................................................................... 	 26
	27	Total prepayments (add lines 23 through 26; enter here and on line 14) ...................................................	 27
Have you been audited by the Internal Revenue Service in the past 5 years?.............................................................	 Yes	
(if Yes, list years)

Designee’s name (print)	
Third – party 		 Yes	
No
designee 	 Designee’s email address

No

Designee’s phone number

(		

(see instructions) 				

)

PIN

Certification: I certify that this return and any attachments are to the best of my knowledge and belief true, correct, and complete.
Authorized
person
Paid
preparer
use
only

(see instr.)

Printed name of authorized person	

Signature of authorized person	

	 Email address of authorized person	

Telephone number	

(		

	 Firm’s name (or yours if self-employed)		
	 Signature of individual preparing this return	

Official title

Address	

	 Email address of individual preparing this return		

)

Firm’s EIN	

Date
Preparer’s PTIN or SSN

City	
Preparer’s NYTPRIN	

State	
or	

ZIP code

Excl. code	 Date

Attach a copy of your complete federal return and a copy of your New York Captive Insurance Company Annual Statement as filed with
the New York State Department of Financial Services.
See instructions for where to file.

431002230094