Form 4583 - Michigan Business Tax Simplified Return - 2011 Page 2
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1
24583, Page 2
FEIN or TR Number
PART 2: PAYMENTS AND REfuNDABlE CREDITS
22. Overpayment credited from prior MBT return ........................................................................................................
22.
00
23. Estimated tax payments ........................................................................................................................................
23.
00
24. Tax paid with request for extension .......................................................................................................................
24.
00
25. Refundable credits from Form 4574, line 31 .........................................................................................................
25.
00
00
26. Total. Add lines 22 through 25. (If not amending, skip to line 28.) ........................................................................
26.
a. Payment made with the original return ................................
27a.
00
AMENDED
27.
RETuRN
b. Overpayment received on the original return ......................
27b.
00
oNlY
c. Add lines 26 and 27a and subtract line 27b from the sum ..... ...................................................
27c.
00
PART 3: TAx DuE/oVERPAYMENT
28. TAx DuE. Subtract line 26 (or line 27c, if amending) from line 21. If less than zero, leave blank ........................
28.
00
29. Underpaid estimate penalty and interest from Form 4582, line 38 ........................................................................
29.
00
% =
00
00
30. Annual return penalty (a)
(b)
plus interest of (c)
. Total ...... 30d.
00
31. PAYMENT DuE. If line 28 is blank, go to line 32. Otherwise, add lines 28, 29 and 30d and enter here ..............
31.
00
32. Overpayment. Subtract lines 21, 29 and 30d from line 26 (or line 27c, if amending).
If less than zero, leave blank (see instructions).....................................................................................................
32.
00
33. CREDIT foRWARD. Amount on line 32 to be credited forward and used as an estimate for next tax year ........
33.
00
34. REfuND. Amount on line 32 to be refunded.........................................................................................................
34.
00
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
Return is due April 30 or on or before the last day of the 4th month after the close of the tax year.
WITHouT PAYMENT: Mail return to:
WITH PAYMENT: Pay amount on
Make check payable to “State of Michigan.”
line 31 and mail check and return to:
Print taxpayer’s FEIN or TR Number, the tax
year, and “MBT” on the front of the check. Do
Michigan Department of Treasury
Michigan Department of Treasury
not staple the check to the return.
P.O. Box 30113
P.O. Box 30783
Lansing, MI 48909
Lansing, MI 48909
+
0000 2011 67 02 27 5
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