Form 4918 - Michigan Annual Flow-Through Withholding Reconciliation Return - 2016 Page 4
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44918, Page 4
Taxpayer FEIN
PART 5: SouRCe oF FloW-THRouGH INCoMe AlloCATeD, oR WITHHolDING PAID, by ANoTHeR TIeR
Carry the sum of all amounts entered in Column C to Part 2, line 19. If entering an amount in line 19, Part 5 must be completed and
included with the return.
30.
A.
b.
C.
Allocated/Apportioned
Amount of Withholding
Source Tier Information
Income
Paid on your behalf
Business Name
Address
City
State
ZIP/Postal Code
FEIN
Tax Year End (MM-DD-YYYY)
Business Name
Address
City
State
ZIP/Postal Code
FEIN
Tax Year End (MM-DD-YYYY)
Business Name
Address
City
State
ZIP/Postal Code
FEIN
Tax Year End (MM-DD-YYYY)
Business Name
Address
City
State
ZIP/Postal Code
FEIN
Tax Year End (MM-DD-YYYY)
Business Name
Address
City
State
ZIP/Postal Code
FEIN
Tax Year End (MM-DD-YYYY)
Business Name
Address
City
State
ZIP/Postal Code
FEIN
Tax Year End (MM-DD-YYYY)
+
9999 2016 50 04 27 2
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