The California Form 570 is a tax return specifically designed for reporting nonadmitted insurance premiums. This form is crucial for individuals and businesses that purchase insurance from insurers not authorized to operate in California. Understanding how to complete this form accurately is essential for compliance and to avoid potential penalties.
For assistance in filling out the California Form 570, please click the button below.
The California Form 570, also known as the Nonadmitted Insurance Tax Return, is a crucial document for individuals and businesses engaging with nonadmitted insurers. This form is utilized to report and calculate taxes on premiums paid for insurance contracts that cover risks located within California. A policyholder must select the appropriate calendar quarter during which the insurance contract took effect or was renewed. The form is divided into several parts, starting with the policyholder's identification details, including business name, address, and taxpayer identification numbers. The tax computation section follows, where policyholders report gross premiums and calculate the total taxable amount, which is subject to a three percent tax rate. Furthermore, the form allows for adjustments related to returned premiums, overpayments, and prepayments. Amended returns can also be filed using this form, allowing taxpayers to correct previous submissions. By adhering to the filing deadlines and providing accurate information, policyholders can ensure compliance with California tax regulations while effectively managing their nonadmitted insurance obligations.
TAXABLE YEAR CALIFORNIA FORM
2013
NONADMITTED INSURANCE TAX RETURN
570
Amended
Select calendar quarter during which the taxable insurance contract(s) took effect or was renewed.
Period ending:
March 31 June 30 September 30 December 31
PART I Policyholder
Business name
First name
DBA (if applicable)
SSN or ITIN FEIN CA Corp. no. CA SOS file no.
Initial Last name
Address (number and street, PO Box, or PMB no.)
Apt. no./Ste. no.
City
State
ZIP Code
Telephone number
()
PART II Tax Computation
1Gross premiums paid or to be paid on risks located entirely within California and California is your principal place of
business or your principal residence. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Gross premiums paid or to be paid by California home state insured, including policies with risks outside California . . . . . . 2 3 Total taxable premiums. Add line 1 and line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Total tax. Multiply line 3 by 3% (.03). (There is no stamping fee) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
53% of returned premiums previously taxed. Attach copies of all contracts. See instructions.
Total premiums returned $ _________________ Quarter/year taxed _________________ Policy No. _____________ . . .
. 5
M M Y Y Y Y
6
Overpayments from prior quarters. Quarter/year _________________
. 6
7
Prepayments. See instructions
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. 7
8
Total premiums returned, overpayments, or prepayments. Add line 5 through line 7
. 8
9
Balance. Subtract line 8 from line 4. If the amount on line 8 is more than the amount on line 4, see instructions
. 9
10
Penalty for late payment of tax. See instructions . .
11
Interest on late payment. See instructions
12Payment due. Add line 9 through line 11. If the result is positive, enter here. Make a check or money order
payable to the “Franchise Tax Board”. See instructions. Check the box if paying via EFT . . . . . . . . . . . . . . . . . . . . . . EFT n . . . . 12
13 Overpayment. Add line 9 through line 11. If result is negative, enter here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14 Overpayment to be applied to the next quarter. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 15 Refund. Subtract line 14 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Check entity type:
Corporation Partnership Limited Liability Company Limited Liability Partnership Individual Other (specify)_________________________
If you are an agent or broker with a valid power of attorney authorizing you to file this return on behalf of the insured, enter the following information:
Business Name
Business Address
Contact Person’s Name
Contact Person’s Phone
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.
Please
___________________________________________________________________________
Sign
Print or type elected officer or authorized person’s name
Here
_____________________________
Elected officer or authorized person’s signature
Date
May the FTB discuss this return with the preparer shown below? See instructions . . . . . Yes No
________________________________________________________________
Check if
Telephone No.
self-employed
(
)
-
Print or type preparer’s name
PTIN
Paid
Preparer’s signature
Preparer’s
FEIN
Use Only
Business name (or yours, if
self-employed) and address
For Privacy Notice, get form FTB 1131.
3681133
Form 570 C1 2012 Side 1
Policyholder Name: ________________________________________________________ Policyholder’s ID No.:________________________
PART III Insurance Contracts – If you have more than 24 policies to report, enter the additional policies on another Side 2 of Form 570. Total each Side 2 on the bottom separately. Do not create a schedule to report additional policies. We only accept and process official versions of Side 2 of Form 570.
PRINT CLEARLY
a
b
c
d
e
Policy Number
Name of each Nonadmitted Insurance Company
Type of Insurance Coverage
Location of Risks
Total Premium
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Side 2 Form 570 C1 2012
3682133
Instructions for Form 570
Nonadmitted Insurance Tax Return
References in these instructions are to the California Revenue and Taxation Code (R&TC) and the California Insurance Code.
What’s New
Do Not Round Cents to Dollars – On this form, do not round cents to the nearest whole dollar. Enter the amounts with dollars and cents.
General Information
A user of this form may have to file up to four Form 570 tax returns in one year if the user purchases nonadmitted insurance contracts in each calendar quarter.
Assembly Bill (AB) 315, effective July 21, 2011, conforms California law to the Nonadmitted and Reinsurance Reform Act (NRRA) that is part of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010, enacted by the federal government and authorizes the collection of tax on 100 percent of the premiums of California home state insured policies. Thus, if a person is determined to be a California home state insured, then all premiums related to all insurance policies obtained from a nonadmitted insurer are subject to tax, as long as the premiums are for policies related to risks within the United States. This
is a change from when California only taxed premiums related to California risk. The NRRA only allows one state to tax a home state insured, so proration of premiums among the states for taxation no longer occurs.
For more information, go to ftb.ca.gov and search for nonadmitted insurance tax.
To receive nonadmitted insurance tax information by email, go to ftb.ca.gov and search for subscription services.
Definitions:
•Home state – the state where the insured maintains its principal place of business, or if individual, the individual’s principal residence; if 100% of the insured risk is located in a state outside the insured’s principal place
of business or principal residence, then it is where the greatest percent of the insured’s taxable premium for that insurance contract is allocated.
•Principal place of business – the state where the insured maintains its headquarters and where the insured’s high-level officers direct, control, and coordinate the business activities; or if the insured’s high-level officers direct, control, and coordinate the business activities in more than one state, the state in which the greatest percentage of the insured’s taxable premium for that insurance contract is allocated; or if the insured maintains its headquarters or the insured’s high-level officers direct, control, and coordinate the business activities outside the U.S., the state to which the greatest percentage of the insured’s taxable premium for that insurance contract is allocated.
•Principal residence – the state where the insured resides for the greatest number of days during a calendar year; or if the insured’s principal residence is located outside the U.S., the state to which the greatest percentage
of the insured’s taxable premium for that insurance contract is allocated.
•Home state insured – or “home state insured applicant” – a person whose home state is California and who has received a certificate or evidence of coverage as set forth in Section 1764 of the Insurance Code or a policy as issued by an eligible surplus line insurer, or a person who is an applicant.
•Multistate risk – means a risk covered by a nonadmitted insurer with insured exposures in more than one state.
The total gross premium paid or to be paid for all nonadmitted insurance placed in a single transaction with one underwriter or group of underwriters, whether in one or more policies, in that calendar quarter during which the taxable insurance contract or contracts took effect or were renewed, is now the entire gross premium charged on all nonadmitted insurance for the California home state insured. Enter only premiums for policies related to risks within the U.S.
Private Mail Box (PMB) – Include the PMB in the address field. Write “PMB” first, then the box number. Example: 111 Main Street PMB 123.
Foreign Address – Enter the information in the following order: City, Country, Province/Region, and Postal Code. Follow the country’s practice for entering the postal code. Do not abbreviate the country’s name.
A Purpose
Use Form 570, Nonadmitted Insurance Tax Return, to determine the tax on premiums paid or to be paid to nonadmitted insurers on contracts covering risks. Also, use Form 570 to file an amended return. See Section E, Amended Returns, for more information.
B Who Must Pay Nonadmitted Insurance Tax
The tax is imposed on a home state insured who independently purchases or renews an insurance contract during the calendar quarter from an insurer, including wholly-owned subsidiaries, not authorized to transact insurance business in California.
If you do not know if the insurer is authorized to conduct business in California, call the FTB Nonadmitted Insurance Desk at 916.845.7448.
The tax will not be imposed on any of the following:
•Insurance coverage for which a tax on the gross premium is due or has been paid by surplus line brokers pursuant to Insurance Code Section 1775.5 (surplus lines tax).
•Gross premiums on businesses governed by provisions of Insurance Code Section 1760.5 (reinsurance of the liability of an admitted insurer and marine, aircraft, and interstate railroad insurance).
•Insurance coverage for which a tax on the gross premium is due or has been paid by risk retention groups pursuant to Insurance Code Section 132.
Agents or brokers with a valid power of attorney to file a return on behalf of the insured must enter the requested information in the space below line 15.
C Tax Rate
The tax rate is three percent (.03). This rate is applied to the gross premium paid or to be paid, less premiums returned because of cancellation or reduction of premium on which a tax has been paid. Do not include a stamping fee.
D When and Where to File
File Form 570 on or before the first day of the third month following the close of any calendar quarter during which a nonadmitted insurance contract took effect or was renewed:
Contract effective date
Return due date
January - March
June 1
April - June
September 1
July - September
December 1
October - December
March 1
Mail Form 570 and payment to:
FRANCHISE TAX BOARD
PO BOX 942867
SACRAMENTO CA 94267-0651
EAmended Returns
Use Form 570 to file an amended return. File an amended return to correct an error on the original return or to claim a refund.
Check the “Amended” box at the top of the form. Attach a copy of the original return behind the amended return and write “copy” in red across the face of the original return. When completing line 1 through line 15 of the amended return, use the amounts that should have been reported on the original return.
Amended returns must be filed within four years of the original due date or within one year from the date of the overpayment, whichever period expires later.
Attach copies of all contracts for changes to correct an error on the original return or to claim a refund.
Do not file an amended return to claim returned premiums. See the Specific Line Instructions for line 5.
F Third Party Designee
If the entity wants to allow the FTB to discuss its 2013 return with the paid preparer who signed it, check the “Yes” box in the signature area of the return. This authorization applies only to the individual whose signature appears in the “Paid Preparer’s Use Only” section of the return. It does not apply to the business, if any, shown in that section.
If the “Yes” box is checked, the entity is authorizing the FTB to call the paid preparer to answer any questions that may arise during the processing of its return. The entity is also authorizing the paid preparer to:
Form 570 Instructions 2012 Page 1
•Give the FTB any information that is missing from the return.
•Call the FTB for information about the processing of the return or the status of any related refund or payments.
•Respond to certain FTB notices about math errors, offsets, and return preparation.
•The entity is not authorizing the paid preparer to receive any refund check, bind the entity to anything (including any additional tax liability), or otherwise represent the entity before the FTB.
The authorization will automatically end one year from the date this tax return was filed. If the entity wants to expand the paid preparer’s authorization, get form FTB 3520, Power of Attorney Declaration for the Franchise Tax Board. If the entity wants to revoke the authorization before it ends, notify the FTB in writing or call 800.852.5711.
Specific Instructions
Part I – Policyholder
Enter the business or individual policy holder name, Doing Business As (DBA), if applicable, address, and identification number. Print
all information using CAPITAL LETTERS. If completing Form 570 by hand, enter all the information requested using black or blue ink.
Part II – Tax Computation
Do not show net or negative amounts on line 1 through line 4 to account for returned premiums. See line 5 for returned premiums. Only use line 1 through line 4 to report taxable premiums paid or to be paid during the calendar quarter.
Line 1 – Enter all gross premiums paid or to be paid on risks located entirely within California for policies entered into or renewed during the calendar quarter.
Line 2 – Enter all gross premiums paid or to be paid by California home state insured for all policies issued by a nonadmitted insurer for coverage both inside and outside of California which were entered into or renewed during the calendar quarter. Note: Enter only premiums for policies related to risks within the U.S.
Line 5 – Enter three percent (.03) of the premiums returned during the calendar quarter because of cancellation or reduction of premiums on which nonadmitted insurance tax was paid.
Enter the quarter that the returned premiums were originally taxed. If the returned premiums are from more than one quarter or policy, attach a schedule showing the amount of returned premiums from each quarter and/or policy.
Returned premiums must be claimed on a return for the calendar quarter during which the returned premiums were received. Refunds resulting from returned premiums must be claimed within four years from the original due date of the return, four years from the date the return was filed or one year from the date of cancellation or reduction of premium, whichever is later.
If you are an agent or broker filing this return on behalf of the insured, the refund will be mailed to you in the name of the insured if a signed Power of Attorney is on file allowing the FTB to do so.
Attach copies of all contracts where there was a reduction of premiums returned or cancellation on which nonadmitted insurance tax was paid.
Line 6 – Enter the amount of overpayment you requested to be applied from a prior quarter that was not applied on a previously filed return. These payments may include amounts from an amended Form 570. Enter the calendar quarter and taxable year as MM-YYYY of the calendar quarter the overpayment occurred. For example, if the calendar quarter and tax year is September 30, 2010, enter 09-2010.
Line 7 – Enter any payments made before filing the return. If the return is being filed after the due date, see the instructions for line 10.
Line 9 – If the amount on line 4 is more than the amount on line 8, subtract line 8 from line 4 and enter the balance on line 9, you have tax due. If the amount on line 8 is more than the amount on line 4, subtract line 4 from line 8 and enter the result in brackets on line 9, your credits exceed your tax.
Line 10 – If you do not pay the tax due by the due date, a penalty of 10% of the amount of tax due will be imposed. Enter 10% of the amount of tax not paid by the due date. (A penalty of 25% of the amount of tax due will be imposed when nonpayment or late payment is due to fraud.)
Line 11 – Interest will be charged on any late payment and penalty from the due date to the date paid. Interest compounds daily and the interest rate is adjusted twice a year. If you do not include interest with your late payment or include only a portion of it, the FTB will compute the interest and bill you for it.
Line 12 – Enter the total amount due. Make your check or money order payable to the “Franchise Tax Board.” Write the calendar quarter (March, June, September, or December), the applicable taxable year, Form 570, and your social security number (SSN), individual taxpayer identification number (ITIN), California corporation number, federal employer identification number (FEIN), or California Secretary of State (SOS) file no. on the check or money order. Check the EFT box if you made your payment by EFT.
Electronic Funds Transfer (EFT) – To submit your nonadmitted insurance tax payment using EFT, use the following tax type code, EFT code 02020. You must use the correct EFT code to ensure proper credit to your FTB account.
Line 14 – Enter the amount of overpayment to be credited to your next quarter’s return.
Part III – Insurance Contracts
Column a – Enter the policy number for each contract. Enter only policies related to risks within the U.S.
Column b – Enter the name of all the Nonadmitted Insurance Companies for each contract.
Column c – Enter the type of insurance coverage provided by the contract.
Column d – Enter the full name or the two letter abbreviation of the state where the risk is located for each contract. If your policy covers more than one state, then use additional lines to list the locations of the risk separately.
Column e – Enter the total premium amount for each contract.
Total – Enter the total of Form 570, Side 2, column e.
Additional Information
If you have questions, contact: FTB Nonadmitted Insurance Desk at 916.845.7448 or call the Withholding Services and Compliance automated number at 888.792.4900.
OR write to:
WITHHOLDING SERVICES AND COMPLIANCE MS F182 FRANCHISE TAX BOARD
PO BOX 942867 SACRAMENTO CA 94267-0651
You can download, view, and print California tax forms and publications at ftb.ca.gov.
OR to get forms by mail write to:
TAX FORMS REQUEST UNIT MS F284 FRANCHISE TAX BOARD
PO BOX 307
RANCHO CORDOVA CA 95741-0307
For all other questions unrelated to withholding or to access the TTY/TDD numbers, see the information below.
Internet and Telephone Assistance
Website:
ftb.ca.gov
Telephone: 800.852.5711 from within the
United States
916.845.6500 from outside the
TTY/TDD:
800.822.6268 for persons with
hearing or speech impairments
Asistencia Por Internet y Teléfono
Sitio web:
Teléfono:
800.852.5711 dentro de los Estados
Unidos
916.845.6500 fuera de los Estados
800.822.6268 personas con
discapacidades auditivas y del habla
Page 2 Form 570 Instructions 2012
Completing the California Form 570 requires attention to detail and accurate reporting of insurance premiums. Follow these steps to ensure proper submission of your Nonadmitted Insurance Tax Return.
After completing these steps, ensure that all information is accurate and legible. Review the form for any errors before mailing it to avoid delays in processing. If you have questions, refer to the contact information provided in the form's instructions.
The California Form 570, also known as the Nonadmitted Insurance Tax Return, is used to report and calculate taxes on premiums paid to nonadmitted insurers. This form is specifically for individuals or businesses that purchase nonadmitted insurance contracts covering risks located within California. The tax is assessed at a rate of three percent on the gross premiums paid or to be paid during the calendar quarter.
Any home state insured who independently purchases or renews an insurance contract with a nonadmitted insurer during a calendar quarter must file Form 570. A home state insured is defined as an individual or business whose principal place of business or residence is in California. If you are unsure whether your insurer is authorized to conduct business in California, you can contact the Franchise Tax Board (FTB) Nonadmitted Insurance Desk.
Form 570 must be filed by the first day of the third month following the end of any calendar quarter during which the nonadmitted insurance contract took effect or was renewed. For example:
Form 570 requires various details to be completed, including:
It is important to provide accurate information, as errors can lead to penalties or delays in processing.
If Form 570 is not filed by the due date, a penalty of 10% of the tax due will be imposed. In cases of fraud, the penalty may increase to 25%. Additionally, interest will be charged on any late payment. Interest accrues daily and is adjusted twice a year. It is advisable to file the form as soon as possible to minimize penalties and interest.
Yes, you can amend Form 570 if you need to correct an error on the original return or claim a refund. To do this, check the "Amended" box at the top of the form and attach a copy of the original return. Amended returns must be filed within four years of the original due date or within one year from the date of the overpayment, whichever is later. Ensure that you use the correct amounts that should have been reported originally.
Failing to select the correct calendar quarter for which the insurance contracts took effect or were renewed. This can lead to inaccurate tax calculations.
Not providing complete information in Part I, such as the policyholder's name, address, or identification number. Incomplete details may delay processing.
Misreporting the gross premiums on lines 1 and 2. It is essential to ensure that only premiums related to risks within the U.S. are included.
Neglecting to attach copies of all relevant contracts when claiming returned premiums on line 5. This oversight can lead to disallowed claims.
Forgetting to check the box for electronic funds transfer (EFT) payments if applicable. This can result in confusion regarding payment methods.
Not filing an amended return within the required timeframe if errors are discovered after submission. Amended returns must be filed within four years of the original due date.
Failing to sign and date the form. An unsigned return will not be processed, leading to potential penalties and interest on unpaid taxes.
The California Form 570 is essential for reporting nonadmitted insurance taxes. It is often accompanied by several other forms and documents that facilitate accurate tax reporting and compliance. Below is a list of these additional forms and documents, along with brief descriptions of their purposes.
Understanding the purpose of these forms and documents can help ensure compliance with California tax regulations. It is crucial to gather all necessary information and documentation when filing the Form 570 to avoid potential issues or delays in processing.
The California Form 100 is similar to the California 570 form as both are tax returns that businesses must file with the Franchise Tax Board. The Form 100 is specifically designed for corporations operating in California, requiring them to report their income, deductions, and tax liabilities. Like the 570, it includes a section for calculating the total tax owed based on gross income. Both forms share a common goal of ensuring compliance with state tax laws, but the Form 100 focuses on corporate entities, while the 570 targets nonadmitted insurance contracts.
Another document that resembles the California 570 is the California Form 540, which is used by individual taxpayers to report their income and calculate their state tax liability. Much like the 570, the Form 540 requires detailed information about income sources and deductions. Both forms involve a thorough computation of tax owed, and they must be filed by specific deadlines to avoid penalties. While the Form 540 is geared toward individual taxpayers, the essential structure and purpose align closely with the 570's focus on tax obligations related to nonadmitted insurance.
The California Form 565 is another document that shares similarities with the California 570. This form is utilized by partnerships to report their income, deductions, and tax liabilities. Both forms require detailed financial information and calculations to determine tax amounts owed. Additionally, they both serve as mechanisms for the state to collect revenue from specific types of entities—nonadmitted insurers in the case of the 570 and partnerships for the Form 565. The emphasis on accurate reporting and compliance is a key feature that links these two forms.
Lastly, the California Form 106 is comparable to the California 570 as it is used by Limited Liability Companies (LLCs) to report their income and pay taxes. Similar to the 570, the Form 106 requires detailed financial disclosures and tax computations. Both forms are essential for ensuring that the respective entities meet their tax obligations in California. While the 570 is focused on nonadmitted insurance, the Form 106 addresses the unique tax responsibilities of LLCs, highlighting the state's approach to different business structures.
When filling out the California Form 570, it’s essential to approach the process with care. Here are nine important do's and don'ts to keep in mind:
By adhering to these guidelines, you can help ensure that your filing process goes smoothly and that you meet all necessary requirements.
Misconceptions about the California 570 Form
Filling out and using the California Form 570 for Nonadmitted Insurance Tax Return can be straightforward if you keep these key points in mind:
By following these guidelines, you can ensure that your filing process is efficient and compliant with California tax regulations.