Form 4 (Final Draft) - Application For Extension Of Time To File Michigan Tax Returns - 2007
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5Michigan Department of Treasury
4 (Rev. 10-07)
Instructions for Application for Extension of Time to File Michigan Tax Returns
Select instructions for the appropriate tax.
FINAL
DRAFT
Individual Income Tax and Fiduciary Tax
10/4/07
Single Business Tax (SBT) and Michigan Business Tax (MBT)
Detach here and mail with your payment. Do not fold or staple the application.
Issued under authority of P.A.
Michigan Department of Treasury, Form 4 (Rev. 10-07)
281 of 1967, 228 of 1975, and
Application for Extension of Time to File Michigan Tax Returns
P.A. 36 of 2007.
Make check payable to "State of Michigan." Print your Social Security or account number and "Michigan extension" on the front of your check.
Mail to: Michigan Department of Treasury, Department 78205, PO Box 78000, Detroit, MI 48278-0205
1. Extension request is for the following tax
2. Month and Year Your Tax Year Ends (
)
3. Federal Employer Identification or TR No.
MM-YYYY
-
Check ONLY ONE
Income Tax*
Fiduciary Tax*
a.
b.
5. Filer's Social Security No.
4.
Check if extension is requested for good
Single Business
Michigan Business
cause - see instructions.
c.
d.
Tax (SBT)
Tax (MBT)
6.
7. Spouse's Social Security No., if filing jointly
Check if an extension was granted for your
* Do not file this form if a refund will
federal income tax return
be shown on return.
9. Tentative Annual Tax
8. Business Name or Trust Name
11. Total Payments Made to Date
10. Taxpayer's Name (First Name, Middle Initial, Last Name) or Fiduciary/Trustee Name
13. Payment Amount
12. Mailing Address
.00
DO NOT WRITE IN THIS SPACE
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