Form 4590 - Michigan Business Tax Annual Return For Financial Institutions - 2011 Page 2
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1
24590, Page 2
FEIN or TR Number
00
29. Recapture of Certain Business Tax Credits from Form 4587, line 12 ...................................................................
29.
00
30. Total Tax Liability. Add lines 28 and 29 .............................................................................................................
30.
PART 2: PAYMENTS, REFUNDABLE CREDITS AND TAX DUE
00
31. Overpayment credited from prior return ..........................................................
31.
00
32. Estimated tax payments ..................................................................................
32.
00
33. Tax paid with request for extension .................................................................
33.
00
34. Refundable credits from Form 4574, line 31 ...................................................
34.
35. Total Payments. Add lines 31 through 34. (If not amending, then skip to line 37) ...............................................
35.
00
a. Payment made with the original return ................................. 36a.
00
AMENDED
36.
RETURN
b. Overpayment received on the original return ....................... 36b.
00
ONLY
c. Add lines 35 and 36a and subtract line 36b from the sum ... .................................................... 36c.
00
00
37. TAX DUE. Subtract line 35 (or line 36c, if amending) from line 30. If less than zero, leave blank .......................
37.
38. Underpaid estimate penalty and interest from Form 4582, line 38 ........................................................................
38.
00
% =
00
00
00
39. Annual return penalty (a)
(b)
plus interest of (c)
. Total ..... 39d.
00
40. PAYMENT DUE. If line 37 is blank, go to line 41. Otherwise, add lines 37, 38 and 39d .....................................
40.
PART 3: REFUND OR CREDIT FORWARD
41. Overpayment. Subtract lines 30, 38 and 39d from line 35 (or line 36c, if amending). If less than zero, leave
00
blank (see instructions)..........................................................................................................................................
41.
00
42. CREDIT FORWARD. Amount on line 41 to be credited forward and used as an estimate for next MBT tax year ....
42.
00
43. REFUND. Amount on line 41 to be refunded.........................................................................................................
43.
Taxpayer Certification.
Preparer Certification.
I declare under penalty of perjury that the information in
I declare under penalty of perjury that this
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
Return is due April 30 or on or before the last day of the 4th month after the close of the tax year.
Make check payable to “State of
WITHOUT PAYMENT - Mail return to:
WITH PAYMENT - Pay amount on line 40
Michigan.” Print taxpayer’s FEIN or
and mail check and return to:
TR Number, the tax year, and “MBT” on
Michigan Department of Treasury
Michigan Department of Treasury
the front of the check.Do not staple the
P.O. Box 30783
P.O. Box 30113
check to the return.
Lansing, MI 48909
Lansing, MI 48909
+
0000 2011 87 02 27 3
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