Form 8916 Reconciliation of Schedule M-3 Taxable Income with Tax R

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I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 8916, PAGE 1 of 2
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20.
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: (NONE)

8916

©

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Schedule M-3 tax reconciliation amount from Part II, line 30, column (d)

1

2a

Life/non-life loss limitation amount

2a

Limitation on non-insurance losses (Form 1120-L, page 1, line 25)
Amount subtracted from policyholders surplus account (Form 1120-L,
page 1, line 26)
(1) Non-life capital loss limitation
(2) Life capital loss limitation

e

f

2b
2c

2d(1)
2d(2)

(1) Non-life charitable deduction limitation

2e(1)

(2) Life charitable deduction limitation

2e(2)

(1) Non-life dual consolidated loss amount disallowed

2f(1)

(2) Life dual consolidated loss amount disallowed

2f(2)
3

3

Combine lines 1 through 2f(2)

4a

(1) Non-life net operating loss deduction

4a(1)

(2) Life operations loss deduction

4a(2)

(1) Non-life dividends received deduction

4b(1)

(2) Life dividends received deduction

4b(2)

(1) Non-life capital loss carryforward used

4c(1)

(2) Life capital loss carryforward used

4c(2)

(1) Non-life charitable deduction carryforward used

4d(1)

(2) Life charitable deduction carryforward used

4d(2)

b

c

d

e

2006

Employer identification number

1

d

OMB No. 1545-XXXX

Attach to Schedule M-3 for Forms 1120, 1120-L, or 1120-PC.

Name of common parent

Signature

Revised proofs
requested

Reconciliation of Schedule M-3 Taxable Income
with Tax Return Taxable Income for Mixed Groups

Department of the Treasury
Internal Revenue Service

b
c

Date

O.K. to print

PRINTS: HEAD TO HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form

Action

Small life insurance company deduction (Form 1120-L, page 1, line 23)

4e

5

Add lines 4a through 4e

5

6

Subtract line 5 from line 3

6

7

Other adjustments to reconcile to taxable income on tax return (attach schedule)

7

8

Total. Combine lines 6 and 7. This amount must equal the amount entered on the consolidated
Form 1120, page 1, line 30; Form 1120-L, page 1, line 27; or Form 1120-PC, Schedule A, line 37

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For Paperwork Reduction Act Notice, see page 2.

Cat. No. 37727E

Form

8916

(2006)

6
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 8916, PAGE 2 of 2
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20.
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: (NONE)

PRINTS: HEAD TO HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form

8916

(2006)

General Instructions

Page

Purpose of Form

Use Form 8916 to reconcile Schedule M-3 taxable income to
tax return taxable income for a mixed group, which is a
consolidated tax group which uses two or more of the
following tax return forms: 1120, 1120-L, 1120-PC. A mixed
group is a consolidated tax group that (1) includes both a
corporation that is an insurance company and a corporation
that is not an insurance company, or (2) includes both a life
insurance company and a property and casualty insurance
company, or (3) includes a life insurance company, a
property and casualty insurance company, and a corporation
that is not an insurance company.

Who Must File

Form 8916 must be filed by a mixed group consisting of
filers of Form 1120, 1120-L, or 1120-PC that is required to
file Schedule M-3.

How To File

Line 7. Other adjustments to reconcile to taxable income
on tax return. Enter on line 7, any other adjustments necessary to reconcile to taxable income reported on the consolidated income tax return from the supporting workpapers and
attach a short explanation of the adjustment.

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Section references are to the Internal Revenue Code unless
otherwise noted.

Attach Form 8916 to the consolidated Schedule M-3.
Taxpayers must summarize the taxpayer tax return taxable
income calculation workpapers on Form 8916 and retain
those workpapers. The taxable income calculation
workpapers need not be submitted with the Form 8916.

Specific Instructions
Line 2a. Life/non-life loss limitation amount. Enter any
life/non-life loss limitation amount from the supporting
workpapers.

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Paperwork Reduction Act Notice

We ask for the information on this form to carry out the
Internal Revenue laws of the United States. You are required
to give us the information. We need it to ensure that you are
complying with these laws and to allow us to figure and
collect the right amount of tax.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in
the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
section 6103.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is:
Recordkeeping
xx hr., xx min.
Learning about the law or the form
x hr., xx min.
Preparing, copying, assembling, and
sending the form to the IRS
x hr., xx min.
If you have comments concerning the accuracy of these
time estimates or suggestions for making this form simpler,
we would be happy to hear from you. See the instructions for
the tax return with which this form is filed.