Form 4577 - Business Tax Schedule Of Shareholders And Officers - 2014

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Attachment 07
Michigan Department of Treasury
4577 (Rev. 03-14), Page 1
2014 MICHIGAN Business Tax Schedule of Shareholders and Officers
For all Corporations claiming the Small Business Alternative or Start-Up Business Credits
Issued under authority of Public Act 36 of 2007.
Taxpayer Name (If Unitary Business Group, Name of Designated Member)
Federal Employer Identification Number (FEIN) or TR Number
Unitary Business Groups Only: Name of Unitary Business Group Member Reporting on This Form
Federal Employer Identification Number (FEIN) or TR Number
PART 1: SHAREHOLDERS AND OFFICERS.
See instructions.
1. A
B
C
D
E
F
G
Name of shareholder (including corporation, trust, or partnership),
FEIN or
% Stock from Col. F less
Check
% Stock with
Member
officer, or family member receiving compensation from the
Social Security number
attribution
any attribution between
(X) if an
% Stock
Number
business (Last, First, Middle)
of shareholder or officer
officer
directly owned
two active shareholders
(See instructions.)
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
Percent of stock (not listed above) owned by shareholders who own less than 10% and receive no compensation:
%
100
Total:
%
Continue below using the same Member Number references from column 1A.
H
I
J
K
L
M
N
Dividends
Total compensation and director
Member
(used to determine
Salaries, wages and/
Employee insurance
fees for officers and/or share-
Share of business income/loss
Total shareholder/officer
Number
active shareholders)
or director fees
holders. Add columns J and K.
income. Add columns L and M.
plans, pensions, etc.
(See instructions.)
If more space is needed, include additional 4577 forms. Identify taxpayer and complete Part 1 and Part 2 on each additional form. (See instructions.)
+
0000 2014 47 01 27 3
Continue on Page 2.

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