1120Pc Form – Fill Out and Use This PDF

The Form 1120-PC is an annual tax return required by the Internal Revenue Service (IRS) for insurance companies that specifically deal in property and casualty insurance in the United States. It provides a detailed report of the company's income, losses, deductions, and taxes due for the year. The form is designed to ensure these companies comply with U.S. tax laws and regulations. To start filling out the Form 1120-PC and ensure your company complies with IRS requirements, click the button below.

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1120Pc Form PDF Details

In the realm of United States corporate taxation, specific forms tailor to distinct sectors, encapsulating the unique financial activities and regulatory requirements they face. Among these, the Form 1120-PC stands out, serving as the U.S. Property and Casualty Insurance Company Income Tax Return, a pivotal document for property and casualty insurance companies operating within the U.S. For the calendar year 2021, or for a fiscal year beginning in 2021, this form acts as a comprehensive report, detailing income, expenditures, and the subsequent tax obligations calculated under a complex framework guided by sections of the Internal Revenue Code. The form delves into various operational facets of an insurance company, including but not limited to premiums earned, losses incurred, and investment income, ensuring a thorough evaluation of the company's tax liability. Additionally, it caters to companies that may be part of a consolidated return, adheres to specific elections under certain tax code sections, and accounts for changes in the company's status, such as amendments to returns or address changes. Significantly, Form 1120-PC also meticulously computes taxable income, factoring in special deductions and credits applicable uniquely to the insurance domain, such as foreign tax credits, general business credits, and calculations involving the base erosion minimum tax. This layered approach not only underscores the form's critical role in maintaining tax compliance among property and casualty insurance entities but also highlights the intricate tax scenarios that these companies navigate, underscoring the nuanced interplay between regulatory obligations and the operational realities of the insurance industry.

Question	Answer
Form Name	1120Pc Form
Form Length	9 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	2 min 15 sec
Other names	1120 pc, pc 1120, mn property tax refund 2020, form 1120 pc instructions

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Form 1120-PC

Department of the Treasury Internal Revenue Service

U.S. Property and Casualty Insurance Company

Income Tax Return

For calendar year 2021, or tax year beginning

, 2021, ending

, 20

▶Go to WWW.IRS.GOV/FORM1120PC for instructions and the latest information.

OMB No. 1545-0123

2021

Check if:

Name

Employer identification number

Consolidated return

Please

(attach Form 851) .

Number, street, and room or suite no. If a P.O. box, see instructions.

Date incorporated

2 Life-nonlife consoli-

dated return . .

type

Schedule M-3

City or town, state or province, country, and ZIP or foreign postal code

Check applicable box if an election

(Form 1120-PC)

has been made under section(s):

attached . . .

Check if:

(1)

Final return

(2)

Name change

(3)

Address change

(4)

Amended return

831(b)

953(c)(3)(C)

953(d)

Taxable income (Schedule A, line 37)

. . . . . . . .

Taxable investment income for electing small companies (Schedule B, line 21) .

. . . . . . . .

Check if a member of a controlled group (attach Schedule O (Form 1120)) . .

. . . . . .

▶

Income tax (see instructions)

. . . . . . . .

Enter amount of tax that a reciprocal must include (see instructions) . . . .

. . . . . . . .

Base erosion minimum tax amount (attach Form 8991)

. . . . . . . .

Add lines 4 through 6

. . . . . . . .

Foreign tax credit (attach Form 1118)

Payments

Credit from Form 8834 (attach Form 8834)

General business credit (attach Form 3800)

Credit for prior year minimum tax (attach Form 8827)

Bond credits from Form 8912

and

Total credits. Add lines 8a through 8e

. . . . . . . .

Subtract line 8f from line 7

. . . . . . . .

Computation

Foreign corporations—Tax on income not connected with U.S. business . .

. . . . . . . .

Personal holding company tax (attach Schedule PH (Form 1120))

. . . .

. . . . . . . .

Other taxes. Check if from:

Form 4255

Form 8611

Other (attach statement)

. .

Total tax. Add lines 9 through 12

. . . . . . . .

Reserved for future use

. . . . . . . .

Tax

15a

2020 overpayment credited to 2021 . . .

15a

Reserved for future use

15b

2021 estimated tax payments (see instructions)

15c

Reserved for future use

15d

Less 2021 refund applied for on Form 4466 .

15e (

)

Enter the total of lines 15a and 15c, less line 15e

15f

Tax deposited with Form 7004

15g

Credit by reciprocal for tax paid by attorney-in-fact under section 835(d) .

15h

Other credits and payments

15i

Reserved for future use

15j

15k

Estimated tax penalty (see instructions). Check if Form 2220 is attached . .

. . . . . . ▶

Amount owed. If line 15k is smaller than the total of lines 13 and 16, enter amount owed

Overpayment. If line 15k is larger than the total of lines 13 and 16, enter amount overpaid

Enter amount from line 18: Credited to 2022 estimated tax ▶

Refunded ▶

Sign Here

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

					May the IRS discuss this return
▲			▲		with the preparer shown below?
					See instructions.	Yes No
	Signature of officer	Date		Title

Paid

Preparer

Use Only

Print/Type preparer’s name	Preparer’s signature	Date		Check	if	PTIN
				Check	if
				self-employed

Firm’s name ▶			Firm’s EIN ▶

Firm’s address ▶			Phone no.

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 64270Q

Form 1120-PC (2021)

Form 1120-PC (2021)												Page 2

Schedule A			Taxable Income—Section 832 (see instructions)
	1	Premiums earned (Schedule E, line 7)						. . . . . . . .			1
	2	Dividends and inclusions (Schedule C, line 17)						. . . . . . . .			2
						(a) Interest received			(b) Amortization of
						(a) Interest received			premium
									premium
	3a	Interest (including tax-exempt interest)
	3a	Interest (including tax-exempt interest)
	b	Interest exempt under section 103
	c	Subtract line 3b from line 3a
Income	d	Taxable interest. Subtract line 3c, column (b), from line 3c, column (a) . . .						. . . . . . . .			3d
Income	6	Capital gain net income (see instructions) (attach Schedule D (Form 1120)) . .						. . . . . . . .			6
	4	Rents						. . . . . . . .			4
	5	Royalties						. . . . . . . .			5
		Net gain or (loss) from Form 4797, Part II, line 17 (attach Form 4797)					. . .	. . . . . . . .
	7						. . .	. . . . . . . .			7
	8	Certain mutual fire or flood insurance company premiums (section 832(b)(1)(D))						. . . . . . . .			8
	9	Income on account of special income and deduction accounts						. . . . . . . .			9
	10	Income from protection against loss account (see instructions)						. . . . . . . .			10
	11	Mutual interinsurers or reciprocal underwriters—decrease in subscriber accounts									11
	12	Reserved for future use						. . . . . . . .			12
	13	Other income (attach statement)						. . . . . . . .			13
	14	Gross income. Add lines 1 through 13			. . . . . . . . . . . .			. . . . . . . .			14
	15	Compensation of officers (see instructions) (attach statement)				. . . . .		. . . . . . . .			15
deductions.)	16	Salaries and wages (less employment credits)						. . . . . . . .			16
deductions.)	17	Agency balances and bills receivable that became worthless during the tax year						. . . . . . . .			17
	17							. . . . . . . .			17
	18	Rents						. . . . . . . .			18
	19	Taxes and licenses						. . . . . . . .			19
	20a	Interest ▶			b Less tax-exempt interest exp. ▶					c Bal. ▶	20c
on	21	Charitable contributions						. . . . . . . .			21
on	22	Depreciation (attach Form 4562)						. . . . . . . .			22
limitations	23	Depletion						. . . . . . . .			23
	23	Depletion						. . . . . . . .			23
	24	Pension, profit-sharing, etc., plans			. . . . . . . . . . . . .			. . . . . . . .			24
	25	Employee benefit programs		. . . . . . . . . . . . . . .				. . . . . . . .			25
	26	Losses incurred (Schedule F, line 14)						. . . . . . . .			26
for	27	Reserved for future use						. . . . . . . .			27
for	28	Other capital losses (Schedule G, line 12, column (g))						. . . . . . . .			28
instructions	28	Other capital losses (Schedule G, line 12, column (g))						. . . . . . . .			28
instructions	29	Dividends to policyholders						. . . . . . . .			29
	29	Dividends to policyholders						. . . . . . . .			29
	30	Mutual interinsurers or reciprocal underwriters—increase in subscriber accounts									30
	31	Other deductions (see instructions) (attach statement)						. . . . . . . .			31
	32	Total deductions. Add lines 15 through 31						. . . . . . . .			32
(See	33	Subtotal. Subtract line 32 from line 14						. . . . . . . .			33
(See	34a	Special deduction for section 833 organizations (Schedule H, line 6) . . .						34a
	34a							34a
Deductions	b	Deduction on account of special income and deduction accounts . . .						34b
Deductions	c	Total. Add lines 34a and 34b						. . . . . . . .			34c
	c	Total. Add lines 34a and 34b						. . . . . . . .			34c
	35	Subtotal. Subtract line 34c from line 33						. . . . . . . .			35
	36a	Dividends received and other special deductions (Schedule C, line 30) . .						36a
	b	Net operating loss deduction						36b
	c	Total. Add lines 36a and 36b						. . . . . . . .			36c
	37	Taxable income. Subtract line 36c from line 35. Enter here and on page 1, line 1									37
												Form 1120-PC (2021)

Form 1120-PC (2021)

Page 3

Schedule B Part I—Taxable Investment Income of Electing Small Companies (section 834) (see instructions)

Income

Deductions

			(a) Interest received	(b) Amortization of
				(b) Amortization of
				premium
				premium
1a	Interest (including tax-exempt interest)
1a	Interest (including tax-exempt interest)
b	Interest exempt under section 103
c	Subtract line 1b from line 1a
d	Taxable interest. Subtract line 1c, column (b), from line 1c, column (a)					1d
2	Dividends and inclusions (Schedule C, line 17)					2
3	Rents					3
4	Royalties					4
5	Gross income from a trade or business, other than an insurance business, and from Form 4797				. . .	5
6	Income from leases described in sections 834(b)(1)(B) and 834(b)(1)(C)					6
7	Capital gain net income from Schedule D (Form 1120), line 18					7
8	Gross investment income. Add lines 1d through 7					8
9	Real estate taxes					9
10	Other real estate expenses					10
11	Depreciation (attach Form 4562)					11
12	Depletion					12
13	Trade or business deductions as provided in section 834(c)(8) (attach statement)					13
14	Interest	. . . . . . . . . . . . . . . . . . . . . . . . . . . . .				14
15	Other capital losses (Schedule G, line 12, column (g))					15
16	Total. Add lines 9 through 15					16
17	Investment expenses (see instructions) (attach statement)					17
18	Total deductions. Add lines 16 and 17					18
19	Subtract line 18 from line 8					19
20	Dividends received and other special deductions (Schedule C, line 30)					20
21	Taxable investment income. Subtract line 20 from line 19. Enter here and on page 1, line 2 . . . .					21

Part II—Invested Assets Book Values

Note: Complete only if claiming a deduction for general expenses allocated to investment income.

		(a) Beginning of tax year	(b) End of tax year
22	Real estate
22	Real estate	22
23	Mortgage loans	23
24	Collateral loans	24
25	Policy loans, including premium notes	25
26	Bonds of domestic corporations	26
27	Stock of domestic corporations	27
28	Government obligations, etc	28
29	Bank deposits bearing interest	29
30	Other interest-bearing assets (attach statement)	30
31	Total. Add lines 22 through 30	31
32	Add columns (a) and (b), line 31	. . . . . . .	32
33	Mean of invested assets for the tax year. Enter one-half of line 32	. . . . . . .	33
34	Multiply line 33 by 0.0025	. . . . . . .	34

35Income base. Line 1b, column (a), plus line 8 less the sum of line 1b, column (b),

	and line 16	35
36	Multiply line 33 by 0.0375	36
37	Subtract line 36 from line 35. Don’t enter less than zero	37
38	Multiply line 37 by 0.25	. . . . . . . . .	38
39	Limitation on deduction for investment expenses. Add lines 34 and 38 . . .	. . . . . . . . .	39

Form 1120-PC (2021)

Form 1120-PC (2021)							Page 4

Schedule C		Dividends, Inclusions, Dividends-Received Deduction, and Other Special Deductions
		(see instructions)

					Dividends and Inclusions

			Income	(a) Subject to section			(b) Dividends and
			Income		832(b)(5)(B)		inclusions
					832(b)(5)(B)		inclusions
1	Dividends from less-than-20%-owned domestic corporations (other than debt-
1
	financed stock)			1
2	Dividends from 20%-or-more-owned domestic corporations (other than debt-financed
	stock)			2
3	Dividends on certain debt-financed stock of domestic and foreign corporations . .			3
4	Dividends on certain preferred stock of less-than-20%-owned public utilities . . .			4
5	Dividends on certain preferred stock of 20%-or-more-owned public utilities . . . .			5
6	Dividends from less-than-20%-owned foreign corporations and certain foreign sales
	corporations (FSCs)			6
7	Dividends from 20%-or-more-owned foreign corporations and certain FSCs . . .			7
8	Dividends from wholly owned foreign subsidiaries and certain FSCs			8
9	Dividends from certain affiliated companies			9
10	Foreign-source portion of dividends received from a specified 10%-owned foreign
	corporation (excluding hybrid dividends) (see instructions)			10
11	Dividends from foreign corporations not included on line 3, 6, 7, 8, or 10 (including any
	hybrid dividend)			11
12a	Subpart F inclusions derived from the sale by a controlled foreign corporation (CFC) of
	the stock of a lower-tier foreign corporation treated as a dividend (attach Form(s)
	5471) (see instructions)			12a
b	Subpart F inclusions derived from hybrid dividends of tiered corporations (attach
	Form(s) 5471) (see instructions)			12b
c	Other inclusions from CFCs under subpart F not included on line 12a, 12b, or 13
	(attach Form(s) 5471)			12c
13	Global intangible low-taxed income (GILTI) (attach Forms 5471 and 8992) . . . .			13
14	Gross-up for foreign taxes deemed paid			14
15	Reserved for future use			15
16	Other dividends (attach statement)			16
17	Total dividends and inclusions. Add lines 1 through 16. Enter here and on Schedule
	A, line 2, or Schedule B, line 2, whichever applies			17
					Dividends Received and
					Other Special Deductions
			Deductions
			Deductions	(a) Subject to section			(b) Total dividends received
				(a) Subject to section			(b) Total dividends received
					832(b)(5)(B)		and special deductions
	Multiply line 1 by 50% (0.50)		. . . . . . . . . . . . . . . . .
18	Multiply line 1 by 50% (0.50)		. . . . . . . . . . . . . . . . .	18
19	Multiply line 2 by 65% (0.65)		. . . . . . . . . . . . . . . . .	19
20	Deduction for line 3 (see instructions)			20
21	Multiply line 4 by 23.3% (0.233)			21
22	Multiply line 5 by 26.7% (0.267)			22
23	Multiply line 6 by 50% (0.50)		. . . . . . . . . . . . . . . . .	23
24	Multiply line 7 by 65% (0.65)		. . . . . . . . . . . . . . . . .	24
25	Enter the amount from line 8		. . . . . . . . . . . . . . . . .	25
26	Total. Add lines 18 through 25. (See instructions for limitation.)			26
27	Total. Add line 26, column (a), and line 9, column (a). Enter here and on Schedule F,
	line 10			27
28	Section 250 deduction (attach Form 8993)			. . . . . . .		28
29	Reserved for future use			. . . . . . .		29

30Total deductions. Add line 26, column (b), and lines 9, 10, 12a, and 28, column (b). Enter here and on Schedule A,

line 36a, or Schedule B, line 20, whichever applies

Form 1120-PC (2021)

Form 1120-PC (2021)		Page 5

Schedule E		Premiums Earned—Section 832 (see instructions)

1 Net premiums written . . . . . . . . . . . . . . . . . . . . . . . . . . .

2Unearned premiums on outstanding business at the end of the preceding tax year: a Enter 100% of life insurance reserves included in unearned premiums

(section 832(b)(7)(A)) and unearned premiums of section 833 organizations. See

	instructions	2a
b	Enter 90% of unearned premiums attributable to insuring certain securities . .	2b
c	Discounted unearned premiums attributable to title insurance	2c
d	Enter 80% of all other unearned premiums. See instructions	2d
e	Total. Add lines 2a through 2d
3	Total. Add lines 1 and 2e

4Unearned premiums on outstanding business at the end of the current tax year:

aEnter 100% of life insurance reserves included in unearned premiums (section 832(b)

	(7)(A)) and unearned premiums of section 833 organizations. See instructions . .	4a
b	Enter 90% of unearned premiums attributable to insuring certain securities . .	4b
c	Discounted unearned premiums attributable to title insurance	4c
d	Enter 80% of all other unearned premiums. See instructions	4d
e	Total. Add lines 4a through 4d
5	Subtract line 4e from line 3
6	Transitional adjustments under section 832(b)(7)(D) (see instructions)
7	Premiums earned. Add lines 5 and 6. Enter here and on Schedule A, line 1

Schedule F Losses Incurred (section 832) (see instructions)

1	Losses paid during the tax year (attach reconciliation to annual statement)

2Balance outstanding at the end of the current tax year for:

a	Unpaid losses on life insurance contracts	2a
b	Discounted unpaid losses	2b
c	Total. Add lines 2a and 2b
3	Add lines 1 and 2c

4Balance outstanding at the end of the preceding tax year for:

a	Unpaid losses on life insurance contracts	4a
b	Discounted unpaid losses	4b
c	Total. Add lines 4a and 4b
5	Subtract line 4c from line 3
6	Estimated salvage and reinsurance recoverable at the end of the preceding tax year
7	Estimated salvage and reinsurance recoverable at the end of the current tax year
8	Losses incurred (line 5 plus line 6 less line 7)
9	Tax-exempt interest subject to section 832(b)(5)(B)	9
10	Dividends-received deduction subject to section 832(b)(5)(B) (Schedule C, line 27)	10

11The increase in policy cash value of section 264(f) policies, as defined in section

	805(a)(4)(F)	11
12	Total. Add lines 9, 10, and 11

13Reduction of deduction under section 832(b)(5)(B). Multiply line 12 by applicable percentage. See instructions . .

14Losses incurred deductible under section 832(c)(4). Subtract line 13 from line 8. Enter here and on Schedule A,

line 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1120-PC (2021)

Form 1120-PC (2021)												Page 6

Schedule G		Other Capital Losses (see instructions)
		Note: Include capital assets sold or exchanged to meet abnormal insurance losses and to pay dividends and similar distributions
		to policyholders.

1	Dividends and similar distributions paid to policyholders							. . . . . . . . .			1
2	Losses paid							. . . . . . . . .			2
3	Expenses paid							. . . . . . . . .			3
4	Total. Add lines 1, 2, and 3							. . . . . . . . .			4
	Note: Adjust lines 5 through 8 to cash method if necessary.
5	Interest received								5
6	Dividends received and inclusions (Schedule C, line 17)					. . . . . . .			6
7	Gross rents, gross royalties, lease income, etc., and gross income from a trade
	or business other than an insurance business including income from Form 4797
	(include gains for invested assets only)			. . . . . . . . . . . .					7
8	Net premiums received								8
9	Total. Add lines 5 through 8							. . . . . . . . .			9
10	Limitation on gross receipts from sales of capital assets. Line 4 less line 9. If zero or less, enter -0- . . . .										10
	(a) Description of capital		(b) Date		(c) Gross		(d) Cost or	(e) Expense		(f) Depreciation allowed		(g) Loss
	(a) Description of capital		(b) Date		(c) Gross		(d) Cost or	(e) Expense		(f) Depreciation allowed		((d) plus (e) less
	asset		acquired		sales price		other basis		of sale	(or allowable)		((d) plus (e) less
	asset		acquired		sales price		other basis		of sale	(or allowable)		the sum of (c) and (f))
												the sum of (c) and (f))

11





12	Totals. Column (c) must not be more than
	line 10. (Enter amount from column (g) on
	Schedule A, line 28, or Schedule B, line
	15, whichever applies.)

Schedule H		Special Deduction and Ending Adjusted Surplus for Section 833 Organizations (see instructions)
1	Healthcare claims incurred during the tax year and liabilities incurred during the tax year under cost-plus contracts										1
2	Expenses incurred during the tax year in connection with the administration, adjustment, or settlement of
	healthcare claims or in connection with the administration of cost-plus contracts							. . . . . . . . .			2
3	Total. Add lines 1 and 2							. . . . . . . . .			3
4	Multiply line 3 by 0.25							. . . . . . . . .			4
5	Beginning adjusted surplus							. . . . . . . . .			5
6	Special deduction. If you checked “No” on line 13 of Schedule I, enter -0- here; you can’t take the special
	deduction. All others subtract line 5 from line 4. If zero or less, enter -0-. Enter amount here and on
	Schedule A, line 34a. See instructions for limitation							. . . . . . . . .			6
7	Net operating loss deduction (Schedule A, line 36b)							. . . . . . . . .			7
8	Net exempt income:
a	Adjusted tax-exempt income							. . . . . . . . .			8a
b	Adjusted dividends-received deduction							. . . . . . . . .			8b
9	Taxable income (Schedule A, line 37)							. . . . . . . . .			9
10	Ending adjusted surplus. Add lines 5 through 9				. . . . . . . . .			. . . . . . . . .			10
												Form 1120-PC (2021)

Form 1120-PC (2021)		Page 7

Schedule I		Other Information (see instructions)

1Check method of accounting:

a Cash

b Accrual

c	Other (specify) ▶

2Check box for kind of company:

a Mutual

b Stock

3At the end of the tax year, did the corporation own, directly or indirectly, 50% or more of the voting stock of a domestic corporation? (For rules of

attribution, see section 267(c).) . . . . . .

If “Yes,” attach a statement showing (a) name and employer identification number (EIN), (b) percentage owned, and (c) taxable income or (loss) before NOL and special deductions of such corporation for the tax year ending with or within your tax year.

4Is the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? . . .

If “Yes,” enter name and EIN of the parent corporation ▶

5At the end of the tax year, did any individual, partnership, corporation, estate, or trust own, directly or indirectly, 50% or more of the corporation’s voting stock? (For rules of attribution, see section 267(c).)

If “Yes,” attach a statement showing name and identifying number. (Don’t include any information already entered on line 4 above.)

Enter percentage owned ▶

6At any time during the tax year, did one foreign person own, directly or indirectly, at least 25% of (a) the total voting power of all classes of stock of the corporation entitled to vote, or (b) the total value of all classes of stock of the corporation? . . . .

If “Yes,” enter:

a Percentage owned, and ▶ b Owner’s country ▶

(c)The corporation may have to file Form 5472, Information Return of a 25% Foreign-Owned U.S. Corporation or a Foreign Corporation Engaged in a U.S. Trade or Business. Enter number of Forms 5472 attached ▶

Yes

7a Enter the total unpaid	losses shown on the
corporation’s annual statement:
(1) For the current tax year:	$
(2) For the previous tax year:	$

bEnter the total unpaid loss adjustment expenses shown on the corporation’s annual statement:

(1) For the current tax year:	$
(2) For the previous tax year:	$

8Does the corporation discount any of the loss reserves shown on its annual statement? . . .

9Enter the amount of tax-exempt interest received or accrued during the tax year: $

10If the corporation has an NOL for the tax year and is electing to forgo the carryback period,

check here . . . . . . . . . . ▶

If the corporation is filing a consolidated return, the statement required by Regulations section 1.1502-21(b)(3) must be attached or the election won’t be valid.

11Enter the available NOL carryover from prior tax years. (Don’t reduce it by any deduction on Schedule A, line 36b.) . . ▶ $

12Is the corporation required to file Schedule UTP (Form 1120), Uncertain Tax Position Statement?

See instructions . . . . . . . . . .

If “Yes,” complete and attach Schedule UTP.

13If the corporation is a Blue Cross or Blue Shield organization described in section 833(c)(2), or other organization described in section 833(c)(3), did it meet the medical loss ratio (MLR) requirements of section 833(c)(5)? . . . . . . . . . .

Enter:

(a)Section 833(c)(5)

MLR numerator . . ▶ $

(b) Section 833(c)(5)
MLR denominator . ▶	$
(c) Section 833(c)(5) MLR ▶	%

14If the corporation is a small company as defined in section 831(b)(2) and elects under section 831(b)(2) (A)(iii) to be taxed on taxable investment income:

(a)Does the corporation satisfy the diversification requirements of section 831(b)(2)(B)(i)(l) because no more than 20% of the net written premiums (or, if greater, direct written premiums) of the corporation for the tax year is attributable to any one

policyholder? . . . . . . . . . . .

(b)If the answer to (a) is “No,” does the corporation satisfy the diversification requirements of section 831(b)(2)(B)(i)(II)? . . . . . . . . . .

Yes No

Form 1120-PC (2021)

Form 1120-PC (2021)		Page 8

Schedule I		Other Information (see instructions) (CONTINUED)

15Does the corporation have gross receipts of at least $500 million in any of the 3 preceding tax years?

(See section 59A(e)(2) and (3).) . . . . . .

If “Yes,” complete and attach Form 8991.

16During the tax year, did the corporation pay or accrue any interest or royalty for which the deduction is not allowed under section 267A? See

instructions . . . . . . . . . . . .

If “Yes,” enter the total amount of the disallowed deductions . . . . . ▶ $

Yes No

17Did the corporation have an election under section 163(j) for any real property trade or business or any farming business in effect during the tax year? See

instructions . . . . . . . . . . . .

18Is the corporation required to file Form 8990, Limitation on Business Interest Expense Under Section 163(j), to calculate the amount of deductible business interest? See instructions . . . . .

Yes No

Schedule L
Schedule L		Balance Sheets per Books
		Note: All filers are required to complete this schedule.

		Assets				Beginning of tax year				End of tax year
		Assets
					(a)		(b)		(c)			(d)
1	Cash
1	Cash
2a	Trade notes and accounts receivable . .
b	Less allowance for bad debts . .		. .	(		)			(	)
3	Inventories
4	U.S. Government obligations . . . .
5	Tax-exempt securities (see instructions) .
6	Other current assets (attach statement) .
7	Loans to shareholders
8	Mortgage and real estate loans . . . .
9	Other investments (attach statement) . .
10a	Buildings and other depreciable assets .
b	Less accumulated depreciation . .		. .	(		)			(	)
11a	Depletable assets
b	Less accumulated depletion . . .		. .	(		)			(	)
12	Land (net of any amortization) . . . .
13a	Intangible assets (amortizable only)		. .
b	Less accumulated amortization . .		. .	(		)			(	)
14	Other assets (attach statement) . . . .
15	Total assets
Liabilities and Shareholders’ Equity
16	Accounts payable
16	Accounts payable
17	Mortgages, notes, bonds payable in less than 1 year
18	Insurance liabilities (see instructions) . .
19	Other current liabilities (attach statement) .
20	Loans from shareholders
21	Mortgages, notes, bonds payable in 1 year or more
22	Other liabilities (attach statement) . . .
23	Capital stock:	a Preferred stock . . .
		b Common stock . . .
24	Additional paid-in capital
25	Retained earnings—appropriated (attach statement)
26	Retained earnings—unappropriated . .
27	Adjustments to shareholders’ equity (attach statement)
28	Less cost of treasury stock						(	)			(	)
29	Total liabilities and shareholders’ equity

Form 1120-PC (2021)

Form 1120-PC (2021)			Page 9

Schedule M-1		Reconciliation of Income (Loss) per Books With Income (Loss) per Return
		Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more. See instructions.

1	Net income (loss) per books		7 Income recorded on books this year not
2	Federal income tax per books . . . .		included in this return (itemize):
3	Excess of capital losses over capital gains		a Tax-exempt interest $

4Income subject to tax not recorded on

	books this year (itemize):	8		Deductions in this tax return not charged
5	Expenses recorded on books this year not			against book income this year (itemize):
5	Expenses recorded on books this year not			against book income this year (itemize):
	deducted in this return (itemize):		a	Depreciation $
a	Depreciation $		b	Charitable contributions $

bCharitable contributions $

c	Travel and entertainment $	9	Add lines 7 and 8
		10	Income (Schedule A, line 35, or Schedule
6	Add lines 1 through 5		B, line 19, if applicable)—line 6 less line 9

Schedule M-2 Analysis of Unappropriated Retained Earnings per Books (line 26, Schedule L)

1	Balance at beginning of year	. . . .
2	Net income (loss) per books

3Other increases (itemize):

4Add lines 1, 2, and 3 . . . . . . .

5	Distributions: a Cash . . . .
	b Stock . . . .
	c Property . . .
6	Other decreases (itemize):
7	Add lines 5 and 6

8Balance at end of year (line 4 less line 7)

Form 1120-PC (2021)

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