DRAFT 09/02/09
Michigan Department of Treasury
Attachment 25
4752 (Rev. 09-09), Page 1
2009 MICHIGAN Business Tax Unitary Business Group
Combined Filing Schedule for Financial Institutions
Issued under authority of Public Act 36 of 2007.
IMPORTANT: Read the instructions before completing this form
Designated Member Name
Federal Employer Identification Number (FEIN) or TR Number
PART 1: UNITARy BUSINeSS GROUP (UBG) MeMBeRS
List the UBG members below, beginning with the Designated Member (DM). If more than one page is needed, repeat the DM’s name
and FEIN or TR Number in the field at the top of the page, but not on line 1.
1.
A
B
Member Name
FEIN or TR Number
PART 2A: APPORTIONMeNT DATA FOR COMBINeD ReTURN
If more than one page is needed to complete Part 1, duplicate answers on lines 2 and 3 on all copies of this page.
A
B
C
Combined Total
Combined Total
Before eliminations
eliminations
After eliminations
2. Michigan Gross Business. Carry 2C to Form 4590, line 10a .......
3. Total Gross Business. Carry 3C to Form 4590, line 10b ...........
+
0000 2009 85 01 27 4
Continue on Page 2.