New York Schedules A, B, C, D, and E - Attachment to Form CT-33-A

Schedules A, B, C, D, and E - Attachment to Form CT-33-A
Form CT-33-A/ATT Schedules A, B, C, D, and E - Attachment to Form CT-33-A Life Insurance Corporation Combined Franchise Tax Return Tax Year 2023
CT-33-A/ATT Schedules A, B, C, D, and E –
Department of Taxation and Finance

Attachment to Form CT-33-A
Life Insurance Corporation
Combined Franchise Tax Return

	 Employer identification number (EIN)	

All filers must enter tax period:

File number	

beginning

ending

Business telephone number	

(   )	

		

	 Legal name of corporation			

	 Mailing name (if different from legal name above) 		

	

	 c/o
	 Number and street or PO Box			
	 City	

State	

NAICS business code number (from NYS Pub 910)	

NYS principal business activity

ZIP code

Trade name/DBA

	 State or country of incorporation

Date received (for Tax Department use only)

	 Date of incorporation

	 Foreign corporations: date began
	 business in NYS

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.

Audit (for Tax Department use only)

For all combined returns and attachments, the corporation responsible for filing Form CT-33-A is designated the parent. The other
corporations included in the combined return are designated subsidiaries.
	 Combined parent corporation legal name	

Parent employer identification number

Metropolitan transportation business tax (MTA surcharge) – During the tax year did you do business, employ capital, own or lease
property, or maintain an office in the Metropolitan Commuter Transportation District (MCTD)? (The MCTD includes counties of New
York, Bronx, Kings, Queens, Richmond, Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk, and Westchester.)
  (Mark an X in the appropriate box.) .................................................................................................................................	Yes	
No
This form must be completed for each corporation in the combined group.
Attach this form to Form CT-33-A, Life Insurance Corporation Combined Franchise Tax Return.

Schedule A – Allocation of reinsurance premiums when location of risks cannot be determined (see Form CT-33-A-I,
Instructions for Forms CT-33-A, CT-33-A/ATT, and CT-33-A/B; attach separate sheet if necessary)
A	
B	 C	D
	
	
Name of ceding company	
Reinsurance premiums	
Reinsurance	
		
received	
allocation %	
			 (see instructions)	

Totals from attached sheet.................................
1  Total (add column D amounts; enter here and include on line 37 of Form CT-33-A or Form CT-33-A/B) 	

499001230094

1

Reinsurance premiums
allocated to New York State
(column B × column C)

Page 2 of 3  CT-33-A/ATT (2023)

Legal name of corporation	

EIN

Schedule B – Computation and allocation of subsidiary capital (see instructions; attach separate sheet if necessary)	
A – Description of subsidiary capital (list the name of each corporation and the EIN here; for each corporation complete columns B through G on the 		
	
corresponding lines below)
	 Item
A
B
C
D
E

A

Item

Name	

	B	

C	

	 % of	
Average fair	
	 voting	
market value	
	stock	
(see instructions)	
	owned		

D	

Current liabilities	
attributable to	
subsidiary capital	

EIN

E	

Net average fair 	
market value	

(column C – column D)	
(see instructions)		

F	

Allocation	
%	
(see instr.)	

G

Value allocated
to New York State		

(column E × column F)

A
B
C
D
E

Totals from attached sheet
	 2	 Totals (add amounts in columns C, D, and E)
			
	
2
	3	Allocated subsidiary capital (add column G amounts; enter here and on line 52 of Form CT-33-A or
		  Form CT-33-A/B) ............................................................................................................................... 	

3

Schedule C – Computation of business and investment capital (see instructions)
	
A	 B	C
	
Beginning of year	
End of year	
   Average fair market
			
value basis
	4	 Total assets (see instructions) .................................	 4
 	 5	 Fair market value adjustment (attach computation;
		  show any negative amounts with a minus (-) sign) ........	 5	

	6	Nonadmitted assets from annual statement..........	6	
	7	Current liabilities (see instructions)..........................	 7	
	8	Assets, excluding subsidiary assets included
		  on line 2, column C, held as reserves under
		  New York State Insurance Law sections 1303,
		  1304, and 1305 (use same method to value
		  assets as on lines 4 through 6) .................................. 	 8

499002230094

	

CT-33-A/ATT (2023)  Page 3 of 3

Schedule D – Computation of adjustment for gains or losses on disposition of property acquired before 			
		
January 1, 1974 (you may no longer report gain or loss in the same manner you report it on your federal income tax return; see instr.)

	
A	
B	
C – Fair market 	
	
Description of property	
Cost	
price or value	
	 (attach separate sheet if necessary)	
(see instructions)	
on Jan. 1, 1974	
	
		
(see instructions)	

D	
Value realized	
on disposition	

E	
New York	
gain or loss	

(see instructions)	

F
Federal
gain or loss

(see instructions)	

(see instructions)

Totals from attached sheet...
	9	
Totals (add amounts in columns E and F)........................................................................	 9
	 10	 New York adjustment (subtract line 9, column F, from line 9, column E; enter here and on line 68 of  
		  Form CT-33-A or Form CT-33-A/B; use a minus sign for negative amounts) .......................................................	 10

Schedule E – Officers (appointed or elected) and certain stockholders (include all officers, whether or not receiving any

	

	

compensation, and all stockholders owning more than 5% of taxpayer’s issued capital stock who received any compensation)
A	
B	 C	D
Name and address	
Social Security	
Official title	
Salary and all other
(give actual residence;	
number		
compensation received
attach separate sheet if necessary)			
from corporation

	
	
	

Totals from attached sheet ..........................................................................................................................................
	11	Totals (add column D amounts; enter here and on line 87 of Form CT-33-A or Form CT-33-A/B) ...........................	11	
Certification: Under the penalties of perjury, I declare that this corporation is allowed to file on a combined basis under New York State
Law and is also liable for the group tax liability, and 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	

Address	

	 Email address of individual preparing this return		

499003230094

Official title

)

Firm’s EIN	

Date
Preparer’s PTIN or SSN

City	
Preparer’s NYTPRIN	

State	
or	

Excl. code	 Date

ZIP code