Form 807 - Michigan Composite Individual Income Tax Return - 2014 Page 3
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92014 807, Page 3
Federal Employer Identification No.
Name of Partnership, S Corporation or Other Flow Through Entity
SCHEDULE A: SCHEDULE OF PARTICIPANTS
Column 1:
Distributive Share
Column 2:
Column 3:
of Michigan Income and
Share
Withholding Paid on Behalf of the
Michigan Guaranteed
of Michigan Tax
Participant *
Payments
Recipient FEIN/SSN
3a:
3b:
Payer FEIN
Withholding
Recipient Name and Address
Recipient FEIN/SSN
3a:
3b:
Payer FEIN
Withholding
Recipient Name and Address
Recipient FEIN/SSN
3a:
3b:
Payer FEIN
Withholding
Recipient Name and Address
Recipient FEIN/SSN
3a:
3b:
Payer FEIN
Withholding
Recipient Name and Address
Recipient FEIN/SSN
3a:
3b:
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, 2 and 3b. Carry
total from Column 1 to page 1, line
16, and Column 3b to page 1, line 23.
* Do not include withholding claimed as a credit on any other Michigan Composite Individual Income Tax Return (Form 807),
Individual Income Tax Return (Form MI-1040), Fiduciary Income Tax Return (Form MI-1041), or refunded on a Michigan
Annual Flow-Through Withholding Reconciliation Return (Form 4918).
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