The California Form 570 is a tax return used to report premiums paid or to be paid for nonadmitted insurance contracts. This form is essential for individuals and businesses who purchase insurance from insurers not authorized to conduct business in California. To ensure compliance, it is important to fill out the form accurately and submit it on time; you can start by clicking the button below.
The California Form 570, also known as the Nonadmitted Insurance Tax Return, is essential for individuals and businesses engaging with nonadmitted insurers. This form is utilized to report and compute taxes on premiums paid for insurance contracts that cover risks located within California. It is important to note that if you are a California home state insured, all premiums for nonadmitted insurance policies are subject to taxation, regardless of where the risk is located. The form requires detailed information, including the policyholder's name, address, and identification numbers, as well as the gross premiums paid for the insurance contracts. Additionally, the form includes sections for calculating the total taxable premiums, determining the tax owed, and reporting any overpayments or refunds. Filing deadlines are specific, and penalties may apply for late submissions. Understanding the requirements and accurately completing Form 570 is crucial to ensure compliance with California tax laws.
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 is essential for those dealing with nonadmitted insurance contracts in the state. The form must be filled out accurately to ensure compliance with tax obligations. Below are the steps to guide you through the process of filling out the form correctly.
What is the purpose of the California Form 570?
The California Form 570, also known as the Nonadmitted Insurance Tax Return, is used to determine the tax on premiums paid or to be paid to nonadmitted insurers on contracts covering risks. It can also be used to file an amended return to correct previous errors or claim refunds.
Who is required to file Form 570?
Any individual or business that independently purchases or renews an insurance contract from a nonadmitted insurer during a calendar quarter must file Form 570. This applies if the insured maintains their principal place of business or residence in California.
What is the tax rate applied on the premiums reported on Form 570?
The tax rate for nonadmitted insurance premiums is three percent (0.03) of the gross premiums paid or to be paid. This rate is applied to premiums less any returned premiums due to cancellation or reduction.
When is Form 570 due?
Form 570 must be filed 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. For example, if the contract was effective in January through March, the due date is June 1.
What should I include in Part I of Form 570?
In Part I, you need to provide the policyholder's name, address, and identification number. This includes the Social Security Number (SSN), Individual Taxpayer Identification Number (ITIN), or Federal Employer Identification Number (FEIN), as well as any applicable business name or Doing Business As (DBA) information.
How do I report returned premiums on Form 570?
Returned premiums should be reported on line 5 of Form 570. You must enter the amount of returned premiums during the quarter due to cancellation or reduction and provide the quarter and year in which those premiums were originally taxed.
What happens if I file Form 570 late?
If Form 570 is filed late, a penalty of 10% of the amount of tax due will be imposed. Additionally, interest will be charged on any late payment from the due date until the payment is made. The interest compounds daily and the rate is adjusted twice a year.
Can I amend my Form 570?
Yes, you can amend Form 570 to correct errors or claim refunds. 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.
How can I contact the Franchise Tax Board for assistance with Form 570?
You can contact the Franchise Tax Board (FTB) Nonadmitted Insurance Desk at 916.845.7448 for specific questions related to Form 570. For general inquiries, you can call 800.852.5711 or visit their website at ftb.ca.gov.
When filling out the California Form 570, many individuals and businesses encounter common pitfalls that can lead to errors or complications. Understanding these mistakes can help ensure a smoother filing process.
One frequent mistake is failing to select the correct taxable year. This form requires you to indicate the specific calendar quarter during which the taxable insurance contract took effect or was renewed. If this selection is incorrect, it can lead to miscalculations in tax owed and potential penalties.
Another common error involves the policyholder information. It’s essential to enter the business or individual’s name accurately, including any "Doing Business As" (DBA) names. Omitting or misspelling this information can cause delays in processing and may lead to issues with tax identification.
Many filers also neglect to provide their identification numbers, such as Social Security Number (SSN) or Federal Employer Identification Number (FEIN). This information is crucial for the Franchise Tax Board to correctly identify and process the tax return. Without it, the return may be considered incomplete.
Another mistake is miscalculating the total taxable premiums. It’s important to correctly add the gross premiums paid on risks located entirely within California to those paid by California home state insureds. Errors in this calculation can result in underpayment or overpayment of taxes.
Some individuals mistakenly include returned premiums in the gross premium calculations. The form clearly states that returned premiums should not be included in the taxable premium amounts. Instead, these should be reported separately in the designated line for returned premiums.
Additionally, failing to sign and date the form is a common oversight. The declaration of the preparer must be signed to validate the return. Without this signature, the return may be rejected, leading to further complications.
Lastly, many filers do not check the box allowing the Franchise Tax Board to discuss the return with the preparer. This can limit communication and delay the resolution of any issues that may arise during the processing of the return.
By being aware of these common mistakes, you can take the necessary steps to avoid them. Double-checking your entries and ensuring all required information is included will help facilitate a smoother filing experience.
The California Form 570 is used for reporting nonadmitted insurance taxes. When filing this form, there are several other documents that may be necessary. Below is a list of these forms and documents, along with brief descriptions of each.
Each of these documents serves a specific purpose and can help ensure that the filing process is complete and accurate. It is important to gather all necessary paperwork to avoid delays or issues with the tax return.
When filling out the California Form 570, it is essential to follow specific guidelines to ensure accuracy and compliance. Here are some important do's and don'ts:
This form applies to anyone considered a California home state insured, regardless of where they live. If you purchase nonadmitted insurance contracts that cover risks in California, you need to file this form.
Even if you believe you don't owe tax, you must still file the California 570 form if you purchased nonadmitted insurance. Failing to file can lead to penalties.
The tax rate for nonadmitted insurance in California is set at 3%. This is a straightforward rate applied to the gross premiums.
The California 570 form has specific due dates. You must file it on or before the first day of the third month following the close of the quarter in which the insurance contract took effect or was renewed.
You must report returned premiums on the form. There’s a specific line for this, and it can affect your overall tax due.
Individuals can also be required to file if they are home state insureds. If you purchase nonadmitted insurance, you might need to complete the form.
Only official versions of the California 570 form are accepted. Ensure you are using the most current version to avoid processing issues.
Late filing can lead to penalties, including a 10% charge on the unpaid tax amount. It’s important to file on time to avoid these fees.
You can only file an amended return within four years of the original due date or one year from the date of overpayment. Be mindful of these timelines.
Here are some important points to remember when filling out and using the California 570 form:
Completing the California 570 form accurately ensures compliance and helps avoid penalties. Take your time to review the instructions carefully.