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Form 4910 - Michigan Corporate Income Tax Unitary Business Group Combined Filing Schedule For Financial Institutions - 2012 Page 3

4910, Page 3

Designated Member FEIN or TR Number

PART 3: AFFILIATeS exCLUDeD FROM THe COMBINeD ReTURN OF FINANCIAL INSTITUTIONS

List every person (with or without nexus) for which the “greater than 50 percent” ownership test of a Michigan Unitary Business Group is satisfied,

which is not included on the combined return of financial institutions supported by this form. Using the list of reason codes for exclusion in the

instructions, identify in column D why each entity is not included in the combined return. If any entity listed here is part of a federal consolidated group,

attach a copy of U.S. Form 851.

29.

Number From

Reason

Check (X) if

U.S. Form 851

Code for

Nexus with

(if applicable)

Name

FEIN or TR Number

Exclusion

Michigan

NAICS Code

PART 4: PeRSONS INCLUDeD IN THe PRIOR COMBINeD ReTURN, BUT exCLUDeD FROM CURReNT ReTURN

List each member included in the immediately preceding combined return of this Designated Member that is not included on the return supported by this

form. An entity that satisfies the criteria of Part 3 and Part 4 should be listed in each part. See column C instructions for a list of reason codes.

30.

Name

FEIN or TR Number

Reason This Entity Is Not on Current Return

0000 2012 46 03 27 5

Form 4910 - Michigan Corporate Income Tax Unitary Business Group Combined Filing Schedule For Financial Institutions - 2012 Page 3

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