Form 4894 - Corporate Income Tax Schedule Of Shareholders And Officers

Form 4894 - Corporate Income Tax Schedule Of Shareholders And Officers - 2014

Michigan Department of Treasury

Attachment 3

4894 (Rev. 05-14), Page 1

2014 MICHIGAN Corporate Income Tax Schedule of Shareholders and Officers

For all Corporations claiming the Small Business Alternative Credit

Issued under authority of Public Act 38 of 2011.

Federal Employer Identification Number (FEIN)

Taxpayer Name (If Unitary Business Group, Name of Designated Member)

Federal Employer Identification Number (FEIN)

Unitary Business Groups Only: Name of Unitary Business Group Member Reporting on This Form

PART 1: QUALIFYING DATA FOR ThE SMALL BUSINESS ALTERNATIVE CREDIT

Complete Part 2 and Part 3 before completing Part 1. See instructions for definition of active shareholder.

1. Compensation and director fees of active shareholders. Add amounts in Part 2, column L, for each active

shareholder. Enter here and on Form 4893, line 7 .................................................................................................

2. Compensation and director fees of officers. Add amounts in Part 2, column L, for each officer who is not an

active shareholder. Enter here and on Form 4893, line 8.......................................................................................

PART 2: ShAREhOLDERS AND OFFICERS.

See instructions.

3. A

% Stock from Col. F

Check

Name of shareholder (including corporation, trust, or partnership),

(X) if

less any attribution

officer, or family member receiving compensation from the

Member

FEIN or

% Stock

% Stock with

between two active

officer

Number

business (Last, First, Middle)

Social Security Number

directly owned

attribution

shareholders

Percent of stock (not listed above) owned by shareholders who own less than 10% and receive no compensation:

100

Total:

0000 2014 18 01 27 4

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Form 4894 - Corporate Income Tax Schedule Of Shareholders And Officers - 2014