Michigan Department of Treasury (Rev. 04-13), Page 1
MICHIGAN Amended Income Tax Return MI-1040X
USE FOR TAX YEAR 2011 AND PRIOR
Issued under authority of Public Act 281 of 1967. Type or print in blue or black ink.
ENTER TAX YEAR you are amending (YYYY)
1.
2. Filer’s First Name
M.I.
Last Name
3. Filer’s Social Security No. (Example: 123-45-6789)
If a Joint Return, Spouse’s First Name
M.I.
Last Name
4. Spouse’s Social Security No. (Example: 123-45-6789)
Home Address (Number, Street, P.O. Box)
City or Town
State
ZIP Code
Married -
Married -
Single
FILING STATUS
Filing Jointly
Filing Separately *
* If married, filing separately, enter Spouse’s name:
5. On Original Return......
......................
......................
6. On This Return ...........
......................
......................
INCOME, ADDITIONS and DEDUCTIONS
A. On Original Return
B. Net Change
C. Correct Amount
7. Adjusted gross income. Explain changes on line 49 ..........................
7.
8. Additions to adjusted gross income ....................................................
8.
9. Total income. Add lines 7 and 8 ..........................................................
9.
10. Subtractions from adjusted gross income ..........................................
10.
11. Balance. Subtract line 10 from line 9 ..................................................
11.
12. Multiply number of exemptions by applicable amount (see instructions)..
12.
13. Taxable income. Subtract line 12 from line 11 ....................................
13.
14. Tax. Multiply line 13 by tax rate (see instructions) ..............................
14.
NONREFUNDABLE CREDITS
15. City Income Tax Credit .......................................................................
15.
16. Public Contribution Credit ...................................................................
16.
17. Community Foundation Credit ............................................................
17.
18. Homeless Shelter/Food Bank Credit ..................................................
18.
19. Credit for Income Tax Imposed by Government Units Outside Michigan
19.
20. Historic Preservation Tax Credit (nonrefundable, attach Form 3581) .
20.
21. College Tuition and Fees Credit (if amending, attach Schedule CT)..
21.
22. Vehicle Donation Credit (if amending, attach vehicle donation certificate)
22.
23. Individual or Family Development Account Credit and/or
Small Business Investment Tax Credit (attach applicable certificate)
23.
24. Renewable Energy Surcharge Credit .................................................
24.
25. Total nonrefundable credits. Add lines 15 through 24 ........................
25.
26. Subtract line 25 from line 14. If line 25 is more than line 14, enter “0” .......
26.
27. Voluntary Contributions (see instructions) ..........................................
27.
28. Use tax due (see instructions) ............................................................
28.
29. Add lines 26, 27 and 28 ......................................................................
29.
REFUNDABLE CREDITS AND PAYMENTS
30. Property Tax Credit (attach MI-1040CR or MI-1040CR-2) ..................
30.
31. Farmland Preservation Credit (attach MI-1040CR-5) .........................
31.
32. Qualified Adoption Expenses (if amending, attach Form MI-8839) ....
32.
33. Stillbirth Credit (if amending, attach Stillbirth Certificate) ...................
33.
34. Michigan Earned Income Tax Credit (attach copy of federal return) ..
34.
35. Energy Efficient Qualified Home Improvement Credit (attach Form 4764)
35.
36. Historic Preservation Credit (refundable, attach Form 3581) .............
36.
37. Michigan tax withheld (if amending, attach Schedule W) ...................
37.
38. Estimated tax, extension payments and credit forward ......................
38.
39. Amount paid with original return, plus additional tax paid after filing (do not include interest or penalty) ...
39.
00
40. Total refundable credits and payments. Add lines 30 through 39 of column C ............................................
40.
00
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