Form 807 - Michigan Composite Individual Income Tax Return - 2012 Page 4
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52012 807, Page 4
Name of Partnership, S Corporation or Other Flow Through Entity
Federal Employer Identification Number
SCHEDULE B: SCHEDULE OF NONPARTICIPANTS
Column 1:
Column 2:
Distributive Share
Withholding Paid on Behalf of the
of Michigan Income
Nonparticipant *
Recipient FEIN/SSN
2a:
2b:
Payer FEIN
Withholding
Recipient Name and Address
Recipient FEIN/SSN
2b:
2a:
Withholding
Payer FEIN
Recipient Name and Address
Recipient FEIN/SSN
2a:
2b:
Payer FEIN
Withholding
Recipient Name and Address
Recipient FEIN/SSN
2b:
2a:
Withholding
Payer FEIN
Recipient Name and Address
Recipient FEIN/SSN
2a:
2b:
Payer FEIN
Withholding
Recipient Name and Address
Check here if additional page(s)
used. Enter totals from additional
page(s), if applicable.
Total columns 1 and 2b. Carry total
from Column 1 to line 15 on your
Composite return.
* Do not include withholding claimed on any other Michigan composite return or refunded on any Michigan Annual Flow-
Through Withholding Reconciliation Return (Form 4918).
.
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