Form 4892 - Michigan Corporate Income Tax Amended Return

4892, Page 3

Taxpayer FEIN

PART 3: PAYMENTS AND TAX DUE (Continued)

B. Correct Amount

51. Total payments available. Subtract line 50 from line 49 ..................................................................................

51.

52. TAX DUE. Subtract line 51 from line 43, column B. If less than zero, leave blank ..........................................

52.

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

53.

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

54.

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

55.

56. PAYMENT DUE. If line 52 is blank, go to line 57. Otherwise, add lines 52 through 55 ..................................

56.

PART 4: REFUND OR CREDIT FORWARD

57. Overpayment. Subtract lines 43, column B, and lines 53, 54 and 55 from line 51.

If less than zero, leave blank (see instructions)...............................................................................................

57.

58. CREDIT FORWARD. Amount on line 57 to be credited forward and used as an estimate for next CIT tax year .

58.

59. REFUND. Subtract line 58 from line 57 ...........................................................................................................

59.

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

WITHOUT PAYMENT. Mail return to:

WITH PAYMENT. Pay amount on line 56. Mail check and return to:

Michigan Department of Treasury

Michigan Department of Treasury, PO Box 30804, Lansing MI 48909

PO Box 30803

Make check payable to “State of Michigan.” Print taxpayer’s FEIN, the tax year,

Lansing MI 48909

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

0000 2016 14 03 27 4

Form 4892 - Michigan Corporate Income Tax Amended Return - 2016 Page 3

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