Form 4891 - Corporate Income Tax Annual Return

4891, Page 2

Taxpayer FEIN

PART 1: CORPORATE INCOME TAX (Continued)

Subtractions from Business Income

27. Income from non-unitary FTEs (Enter loss as negative; include Form 4898; see instructions) ......................... 27.

28. Dividends and royalties received from persons other than U.S. persons and foreign operating entities ........

28.

29. Interest income derived from United States obligations ..................................................................................

29.

30. Income from the production of oil and gas, and/or minerals (see instructions) ................................................

30.

31. Miscellaneous (see instructions) .....................................................................................................................

31.

32. Total Subtractions from Income. Add lines 27 through 31 ..............................................................................

32.

33. Corporate Income Tax Base. Subtract line 32 from line 26. If negative, enter as negative .........................

33.

34. Apportioned Corporate Income Tax Base. Multiply line 33 by percentage on line 9g .....................................

34.

35. Apportioned Income from non-unitary FTEs from Form 4898 (see instructions).............................................

35.

36. Total apportioned Corporate Income Tax Base. Add line 34 and line 35 .........................................................

36.

37a. Available CIT business loss carryforward (see instructions). Enter as positive. .............................................. 37a.

37b.

Check if any loss on line 37a was acquired in this filing period in an IRC 381(a)(1) or (2) transaction (see instructions)

38. Subtract line 37a from line 36. If negative, enter here as negative. A negative number here is the available

business loss carryforward to the next filing period (see instructions) ............................................................

38.

39. Corporate Income Tax Before Credit. Multiply line 38 by 6% (0.06). If less than zero, enter zero ..............

39.

PART 2: TOTAL CORPORATE INCOME TAX

40. Small Business Alternative Credit (SBAC) from Form 4893, line 14 or line 18, whichever applies .................

40.

41. Tax Liability after SBAC. Subtract line 40 from line 39. If less than or equal to $100, enter zero.

If apportioned or allocated gross receipts are less than $350,000, enter zero (see instructions) ...................

41.

42. Recapture of Certain Business Tax Credits from Form 4902, line 18 ..............................................................

42.

43. Total Tax Liability. Add lines 41 and 42 ............................................................................................................

43.

PART 3: PAYMENTS AND TAX DUE

UBGs include on lines 44 through 47 payments from all members as reported on Form 4897.

44. Overpayment credited from prior period return (MBT or CIT) .........................................................................

44.

45. Estimated tax payments ..................................................................................................................................

45.

46. Flow-Through Withholding payments ..............................................................................................................

46.

47. Tax paid with request for extension .................................................................................................................

47.

48. Payment total. Add lines 44 through 47. .........................................................................................................

48.

49. TAX DUE. Subtract line 48 from line 43. If less than zero, leave blank ...........................................................

49.

50. Underpaid estimate penalty and interest from Form 4899, line 38 ..................................................................

50.

51. Annual Return Penalty (see instructions) ........................................................................................................

51.

52. Annual Return Interest (see instructions) ........................................................................................................

52.

53. PAYMENT DUE. If line 49 is blank, go to line 54. Otherwise, add lines 49 through 52 ..................................

53.

PART 4: REFUND OR CREDIT FORWARD

54. Overpayment. Subtract lines 43, 50, 51 and 52 from line 48 . If less th an zero, leave blank (see instructions) ..

54.

55. CREDIT FORWARD. Amount on line 54 to be credited forward and used as an estimate for next CIT tax year ...

55.

56. REFUND. Subtract line 55 from line 54 ...........................................................................................................

56.

Taxpayer Certification.

Preparer Certification.

I declare under penalty of perjury that the information in this

I declare under penalty of perjury that this

return and attachments is true and complete to the best of my knowledge.

return is based on all information of which I have any knowledge.

Preparer’s PTIN, FEIN or SSN

By checking this box, I authorize Treasury to discuss my return with my preparer.

Authorized Signature for Tax Matters

Preparer’s Business Name (print or type)

Authorized Signer’s Name (print or type)

Date

Preparer’s Business Address and Telephone Number (print or type)

Title

Telephone Number

Return is due April 30 or on or before the last day of the 4th month after the close of the tax year.

WITHOUT PAYMENT. Mail return to:

WITH PAYMENT. Pay amount on line 53. Mail check and return to: Michigan Department of Treasury,

Michigan Department of Treasury,

PO Box 30804, Lansing MI 48909. Make check payable to “State of Michigan.” Print taxpayer’s FEIN, the tax

PO Box 30803, Lansing MI 48909

year, and “CIT” on the front of the check. Do not staple the check to the return.

0000 2016 12 02 27 0

Form 4891 - Corporate Income Tax Annual Return - 2016 Page 2

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