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Maine Free Printable 2023 Form INS-4 for 2024 Maine Insurance Premiums Tax Return

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Insurance Premiums Tax Return
2023 Form INS-4

Print Clear Form INS-4 Maine Revenue Services 2023 Insurance Premiums Tax Return 99 *2234001* Federal EIN NAIC ID Number Period Covered Due Date January 1 - December 31, 2023 March 15, 2024 CHECK ALL THAT APPLY: Initial return Business Name (Line 1) Amended return Business Name (Line 2) Final return Risk retention group Street Address and/or Post Office Box Domiciled in Maine City State ZIP Code Change of name/address .00 Enter total assets reported on annual statement: Part A – Maine Tax Computation Premiums: 1a. Accident and Health Premiums ........................................................................................................... 1a. .00 1b. Life Premiums...................................................................................................................................... 1b. .00 1c. Property and Casualty Premiums (other than Workers’ Compensation Premiums) .............................1c. .00 1d. Workers’ Compensation Premiums ..................................................................................................... 1d. .00 1e. Title Insurance Premiums .................................................................................................................... 1e. .00 1f. Annuity Considerations received this tax year (See Instructions) ........................................................ 1f. .00 1g. Annuity Considerations received prior to January 1, 1999 taxable this year (See Instructions).......... 1g. .00 1h. Other Premiums .................................................................................................................................. 1h. .00 Total Premiums (Add lines 1a through 1h).......................................................................................1i. .00 1i. Deductions from Schedule 1: 2. Direct return premiums or deposits thereon (Schedule 1, line 8, column A) ......................................... 2. .00 3. Dividends paid, credited or allowed on direct premiums (Schedule 1, line 8, column B) ...................... 3. .00 4. Premiums exempt under qualified pension plans (Schedule 1, line 8, column C)................................. 4. .00 5. Other Deductions (Schedule 1, line 8, column D) ................................................................................. 5. .00 6. Total Deductions (Add lines 2, 3, 4 and 5. Total should equal Schedule 1, line 8, column E) ......... 6. .00 Revised: December 2023 Form INS-4, Page 2 Maine Revenue Services 2023 Insurance Premiums Tax Return 99 *2234002* Federal EIN Tax: 7. 8. Total net taxable premiums (Part A, line 1i minus line 6) ................................................ 7. Net premiums on qualified group disability policies written by a large domestic insurer taxable at 2.55% ............................ 8a. .00 X 2.55% = ..... 8b. .00 Net premiums on qualified group disability and certified long-term care policies taxable at 1% ............................................. 9a. X 1.00% = ..... 9b. .00 10. Net premiums taxable at 2% (Line 7 less lines 8a and 9a) ....................................... 10a. X 2.00% = ... 10b. .00 11. Total Tax (Total of lines 8b, 9b, and 10b. Cannot be less than zero.) .....................................................................11. .00 9. Part B – Retaliatory Tax Computation from Schedule 2 Enter the United States Postal Service two letter state abbreviation for your state of incorporation: 12. Gross Premiums (Schedule 2, line 8, column A)..................................................................................12. .00 13. Allowable Deductions (Schedule 2, line 8, column B) ..........................................................................13. .00 14. Net Taxable Premiums (Schedule 2, line 8, column C) ........................................................................14. .00 15. Premium Tax on basis of state of incorporation (Schedule 2, line 8, column E) ..................................15. .00 Part C – Tax Due 16. Enter the greater of Part A, line 11 or Part B, line 15 ...........................................................................16. .00 17. Nonrefundable Tax Credits (Attach schedule - see instructions) .........................................................17. .00 18. Net Tax (line 16 minus line 17)..............................................................................................................18. .00 19. Refundable Tax Credits (Attach schedule - see instructions) ...............................................................19. .00 20. Estimated Payments ............................................................................................................................20. .00 21. Balance Due (if line 18 is greater than the sum of lines 19 and 20, enter the difference) ....................21. .00 Note: Taxpayers with annual tax liabilities of $10,000 or more are required to remit tax payments electronically. See MRS Rule 102 on the MRS website at www.maine.gov/revenue/publications/rules for details. 22. Overpayment (if the sum of lines 19 and 20 is greater than line 18, enter the difference) ...................22. .00 23a. Portion of overpayment on line 22 to be APPLIED to next year’s ESTIMATED tax .........................23a. .00 23b. Portion of overpayment on line 22 to be REFUNDED ......................................................................23b. .00 a Services Maine Revenue Form INS-4, Page 3 2023 99 Insurance Premiums Tax Return *2234003* Federal EIN 2024 Estimated Tax The 2024 tax payments must be made on an estimated basis. The April and June installments must each equal at least 35% of the total tax liability for 2023 or 35% of the total tax liability for 2024. The October installment must equal 15% of the total tax liability for 2023 or 15% of the total tax liability for 2024. See Form INS-1 for details. (36 M.R.S. § 2521-A). Affidavit and Signature Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Date Signature Title Must be signed by the President, Treasurer, Secretary, Chief Accounting Officer or Attorney-in-fact of a Reciprocal Insurer. Contact Person Phone # Email Address Date Preparer’s Signature Preparer’s ID Number Important: Your return must include required attachments. See page 3 of the instructions for more information. Use the Maine Tax Portal at revenue.maine.gov to file, pay, correspond with MRS, and manage your account. Schedule 1 Deductions by Premium Type Form INS-4 2023 99 *2234004* For Form INS-4, Part A, lines 2-6 Taxpayer Name 2023 Tax Year _______________ Federal EIN Column A Direct Return Premiums Column B Dividends Paid Column C Qualified Pension Plans Column D Other Deductions 1. Accident & Health  2. Life 3. Front End Annuity Considerations 4. Property & Casualty (Exclude Title & Workers’ Comp) 5. Title 6. Workers’ Comp 7. Other 8. Totals Columns B through D do not apply to Risk Retention Groups. Enter line 8, column A amount on Form INS-4, line 2. Enter line 8, column B amount on Form INS-4, line 3. Enter line 8, column C amount on Form INS-4, line 4. Enter line 8, column D amount on Form INS-4, line 5. Attach documentation to support amount claimed. Column E Totals Form INS-4 2023 Schedule 2 Retaliatory Tax 99 *2234005* For Form INS-4, Part B, Lines 12-15 Note: This schedule must be completed by all insurers not incorporated in Maine. All amounts must be in U.S. dollars. Taxpayer Name 2023 Tax Year _______________ Federal EIN Column A Gross Premiums Column B Allowable Deductions Column C Net Taxable Premiums Column D Tax Rate - State of Incorporation 1. Accident & Health  2. Life  3. Annuity  4. Property & Casualty (Excludes Title & Workers’ Comp)  5. Title  6. Workers’ Comp  7. Other  8. Totals Column D - enter the tax rate as a decimal (for example, enter 2.5% as .025 or enter 3% as .03). Column E - if minimum tax applies, enter minimum tax. Do not include fees. (See Schedule 2 Instructions) Enter line 8, column A amount on Form INS-4, line 12. Enter line 8, column B amount on Form INS-4, line 13. Attach documentation to support amount claimed. Enter line 8, column C amount on Form INS-4, line 14. Enter line 8, column E amount on Form INS-4, line 15. Column E Annual Tax Due
Extracted from PDF file 2023-maine-ins-4.pdf, last modified November 2023

More about the Maine INS-4 Individual Income Tax TY 2023

We last updated the Insurance Premiums Tax Return in February 2024, so this is the latest version of INS-4 , fully updated for tax year 2023. You can download or print current or past-year PDFs of INS-4 directly from TaxFormFinder. You can print other Maine tax forms here.


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Other Maine Individual Income Tax Forms:

TaxFormFinder has an additional 61 Maine income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Income Tax Instructions Form 1040ME Instructions
Form 1040ES-ME Vouchers and Instructions for Estimated Tax Payments
Schedule PTFC Schedule PTFC Property Tax Fairness Credit
Form 1040EXT-ME Extension Payment Voucher
Schedule B Minimum Tax Worksheet for Schedule B

Download all ME tax forms View all 62 Maine Income Tax Forms


Form Sources:

Maine usually releases forms for the current tax year between January and April. We last updated Maine INS-4 from the Revenue Services in February 2024.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Maine INS-4

We have a total of two past-year versions of INS-4 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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