Form 4911 - Michigan Corporate Income Tax Schedule Of Flow-Through Withholding - 2012

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Michigan Department of Treasury
Attachment 5
4911 (Rev. 03-12)
2012 Michigan Corporate Income Tax Schedule of Flow-Through Withholding
Issued under authority of Public Act 38 of 2011.
Complete this form if Flow-Through Withholding was withheld on behalf of the taxpayer by a Flow-Through Entity, and the Flow-Through Entity’s tax
year ended with or within the taxpayer’s filing period. Sum the amount of withholding in Column E and carry to Form 4891, line 44; Form 4905, line 44;
or Form 4908, line 25. (If amending a return, carry the sum to Form 4892, line 44; Form 4906, line 44; or Form 4909, line 25.)
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 the Unitary Business Group Member Reporting on This Form
A
B
C
D
E
Check if
the Flow-
Withholding Paid by the
Through
Income from the
Flow-Through Entity on
Flow-Through Entity Name
FEIN
is Unitary
Flow-Through Entity
Behalf of this Taxpayer
If more space is needed, include additional 4911 forms. Identify the taxpayer by Name and FEIN in the appropriate fields at the
top of the page.
+
0000 2012 48 01 27 5

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