Form 4588 - Insurance Company Annual Return Formichigan Business And Retaliatory Taxes - 2008 Page 2

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4588, Page 2

FEIN or TR Number

Foreign and alien insurers complete lines 28 through 43. Domestic insurers complete line 28, then go to line 44.

28. Enter amount from line 27 ......................................................................................................................................

28.

TAXES

State of Incorporation

Michigan

X X X X X X X X

29. State of incorporation tax.......................................................................

29.

X X X X X X X X

30. Michigan Business Tax from line 28 ......................................................

30.

FEES AND ASSESSMENTS

31. Annual statement filing fee ....................................................................

31.

X X X X X X X X

32. Certificate of Authority renewal fee ........................................................

32.

X X X X X X X X

33. Certificate of Compliance ......................................................................

33.

X X X X X X X X

34. Certificate of Deposit .............................................................................

34.

X X X X X X X X

35. Certificate of Valuation ...........................................................................

35.

36. Enter total of other fees paid in the state of incorporation.

Attach a detailed schedule of fees.........................................................

36.

X X X X X X X X

37. Fire Marshall Tax ...................................................................................

37.

38. Second Injury Fund ...............................................................................

38.

39. Silicosis and Dust Disease Fund ...........................................................

39.

40. Safety Education and Training Fund .....................................................

40.

41. Enter total of all other assessments.

Attach a detailed schedule of assessments ..........................................

41.

TOTAL

42. Total Taxes, Fees and Assessments. Add lines 29 through 41 .............

42.

43. Retaliatory Amount. Subtract line 42, column B, from column A. If less than zero, enter zero..............................

43.

44. Total Tax Liability. Add lines 28 and 43. Domestic insurers, enter amount from line 28 ......................................

44.

PAYMENTS, REFUNDABLE CREDITS AND TAX DUE

45. Credit forward from 12/31/2007 Single Business Tax Insurance Return, Form 1366, line 60 ................................

45.

46. Estimated tax payments .........................................................................................................................................

46.

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

47.

48. Refundable Credits from Form 4596, line 5............................................................................................................

48.

49. Total Payments. Add lines 45 through 48. (Then, if not amending, skip to line 51.) ..............................................

49.

a. Payment made with the original return ................................. 50a.

AMENDED

50.

b. Overpayment received on the original return ....................... 50b.

RETURN

ONLY

c. Add lines 49 and 50a and subtract line 50b from the sum ... .................................................... 50c.

51. TAX DUE. Subtract line 49 (or line 50c, if amending) from line 44. If less than zero, leave blank .........................

51.

52. Underpaid estimate penalty and interest from Form 4582, line 38. ........................................................................

52.

% =

53. Annual return penalty

plus interest of

. Enter total .......

53.

54. PAYMENT DUE. If line 51 is blank, go to line 55. Otherwise add lines 51 through 53 ...........................................

54.

OVERPAYMENT, REFUND OR CREDIT FORWARD

55. Overpayment. Subtract lines 44, 52 and 53 from line 49 (or line 50c, if amending). If less than zero, leave

blank. (See instructions.) ........................................................................................................................................

55.

56. CREDIT FORWARD. Amount of overpayment on line 55 to be credited forward ..................................................

56.

57. REFUND. Amount of overpayment on line 55 to be refunded ................................................................................

57.

Taxpayer Certification.

Preparer Certification.

I declare under penalty of perjury that the information in

I declare under penalty of perjury that this

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