Form 4567 - Michigan Business Tax Annual Return - 2009

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Michigan Department of Treasury
Check if this is an
4567 (Rev. 10-09), Page 1
amended return.
2009 MICHIGAN Business Tax Annual Return
.
Attach supporting documents
Issued under authority of Public Act 36 of 2007.
MM-DD-YYYY
MM-DD-YYYY
Return is for calendar year 2009 or for tax year beginning:
and ending:
1.
2. Name (print or type)
7. Federal Employer Identification Number (FEIN) or TR Number
Doing Business As (DBA)
8. Organization Type (LLC or Trust, see instructions)
C Corporation /
Individual
LLC C Corporation
Street Address
S Corporation /
City
State
ZIP/Postal Code
Country Code
Fiduciary
LLC S Corporation
3. Principal Business Activity
4. Business Start Date in Michigan
Partnership / LLC Partnership
5. NAICS (
Code
6. If Discontinued, Effective Date
North American Industry Classification System)
Check if Filing Michigan Unitary Business Group Return.
9.
(Attach Form 4580.)
Check if you have sales receipts from transportation
10.
services.
11.
Apportionment Calculation
00
a. Michigan Sales (if no Michigan sales, enter zero) .................................................................
11a.
00
b. Total Sales .............................................................................................................................
11b.
%
c. Apportionment Percentage. Divide line 11a by line 11b ........................................................
11c.
PART 1: MODIFIED GROSS RECEIPTS TAX
00
12. Gross Receipts (see instructions)......................................................................................................................
12.
Subtractions from Gross Receipts
00
13. Inventory acquired during tax year ....................................................................................................................
13.
00
14. Depreciable assets acquired during tax year ....................................................................................................
14.
00
15. Materials and supplies not included in inventory or depreciable property .........................................................
15.
00
16. Staffing Company: Compensation of personnel supplied to customers ............................................................
16.
If qualified for the Small Business Alternative Credit, skip to line 18.
00
17. Deduction for contractors in SIC Codes 15, 16 and 17 .....................................................................................
17.
SIC Code:
00
18. Film rental or royalty payments paid by a theater owner to a film distributor and/or producer ..........................
18.
19. Qualified Affordable Housing Project (QAHP) Buyer’s Deduction
00
a. Gross receipts attributable to residential rentals in Michigan ........... 19a.
b. Number of residential rent restricted units in Michigan owned
by QAHP ........................................................................................... 19b.
c. Total number of residential rental units in Michigan owned by QAHP ... 19c.
%
d. Divide line 19b by line 19c and enter as a percentage .................... 19d.
00
e. Multiply line 19a by line 19d ............................................................. 19e.
00
f. Limited dividends or other distributions made to owners of project .... 19f.
00
g. Qualified Affordable Housing Project Deduction. Subtract line 19f from line 19e ........................................ 19g.
20. Payments made by taxpayers licensed under Article 25 or Article 26 of the Occupational Code
00
to independent contractors licensed under Article 25 or Article 26 ....................................................................
20.
00
21. Miscellaneous (see instructions) .......................................................................................................................
21.
00
22. Total Subtractions from Gross Receipts. Add lines 13 through 18 and 19g through 21 ....................................
22.
00
23. Modified Gross Receipts. Subtract line 22 from line 12. If less than zero, enter zero .......................................
23.
00
24. Apportioned Modified Gross Receipts Tax Base. Multiply line 23 by percentage on line 11c ..........................
24.
00
25. Multiply line 24 by 0.8% (0.008) .......................................................................................................................
25.
26. Enrichment Prohibition for dealers of personal watercraft or new motor vehicles. Enter amount collected
00
during tax year ...................................................................................................................................................
26.
00
27. Modified Gross Receipts Tax Before All Credits. Enter the greater of line 25 or line 26 .............................
27.
+
0000 2009 11 01 27 9
Continue on Page 2

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