Form 4920 - Michigan Flow-Through Withholding Opt-Out Schedule - 2014
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Michigan Department of Treasury
Attachment 2
4920 (Rev. 04-14)
2014 Michigan Flow-Through Withholding Opt-Out Schedule
Issued under authority of Public Act 38 of 2011 and PA 15 of 2013.
FTE Federal Employer Identification Number (FEIN)
Flow-Through Entity (FTE) Name
A
B
C
Tentative Distributive Share
Member Information
FEIN
of Taxable Income
Name
Address
City
State
ZIP/Postal Code
Name
Address
City
State
ZIP/Postal Code
Name
Address
City
State
ZIP/Postal Code
Name
Address
City
State
ZIP/Postal Code
Name
Address
City
State
ZIP/Postal Code
Name
Address
City
State
ZIP/Postal Code
Name
Address
City
State
ZIP/Postal Code
If more space is needed, include additional copies of Form 4920. Repeat the taxpayer name and FEIN at the top of every copy.
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9999 2014 54 01 27 4
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