Form 165 - Annual Return For Sales, Use And Withholding Taxes

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Michigan Department of Treasury
165 (Rev. 08-12)
Check box if this is an
Annual Return for Sales, Use and Withholding Taxes
amended return.
Taxpayer's Business Name
Account Number
Amended Return
Return Year
Date Due
Amendment Date
File this return by February 28. Do not use this form to replace a monthly or quarterly return.
B. Sales Tax
A. Use Tax: Sales & Rentals
6%
6%
Sales and Use Tax
1.
1.
Gross sales (including sales by out-of-state vendors subject to use tax) ......
1.
2.
2.
Rentals of tangible property and accommodations .......................................
2.
3.
3.
Telecommunications services ........................................................................
3.
4.
4.
Add lines 1, 2, and 3 .....................................................................................
4.
5. ALLOWABLE DEDUCTIONS
5a.
a.
Resale ...........................................................................................................
5a.
b.
b.
Industrial processing or agricultural producing ..............................................
b.
c.
c.
Interstate commerce ......................................................................................
c.
d.
d.
Exempt services ............................................................................................
d.
e.
e.
Sales on which tax was paid to Secretary of State........................................
e.
f.
f.
Food for human/home consumption ..............................................................
f.
g.
g.
Bad debts ......................................................................................................
g.
h.
h.
Michigan motor fuel or diesel fuel tax ............................................................
h.
i.
i.
Other. Identify: ____________________________ ......................................
i.
j.
j.
Tax included in gross sales (line 1)................................................................
j.
k.
k.
Total allowable deductions. Add lines 5a - 5j .................................................
k.
6.
6.
Taxable balance. Subtract line 5k from line 4 ................................................
6.
x .06
x .06
7.
7.
Tax Rate ........................................................................................................
7.
8.
8.
Gross tax due. Multiply line 6 by line 7 ..........................................................
8.
9.
9.
Tax collected in excess of line 8 ....................................................................
9.
10.
10.
Add lines 8 and 9 ...........................................................................................
10.
11.
11.
TOTAL discount allowed (see instructions) ..............................................
11.
12.
12.
Total tax due. Subtract line 11 from line 10 ....................................................
12.
13.
13.
Tax payments in current year (after discounts)..............................................
13.
Use Tax on Items Purchased for Business or Personal Use *
x .06 =
14b.
14.
Enter your taxable purchases ........................................................
14a.
15.
15.
Tax payments made in the current year .............................................................................................................
.
Withholding Tax
16.
16.
Gross Michigan payroll, pension, and other taxable compensation for the year ................................................
17.
Number of W-2, and 1099 forms enclosed .......................................
17.
18.
18.
Total Michigan income tax withheld per W-2 and 1099 forms ............................................................................
19.
19.
Total Michigan income tax withholding paid during current tax year ..................................................................
Summary
20.
20.
Total sales, use and withholding taxes due. Add lines 12A, 12B, 14b and 18 ....................................................
21.
21.
Total sales, use and withholding taxes paid. Add lines 13A, 13B, 15 and 19 .....................................................
22.
If line 21 is greater than line 20, enter overpayment ........................
22.
23.
Amount of line 22 to be credited forward on your account.
We will notify you when your credit is verifi ed and available .............
23.
24.
Amount of line 22 to be refunded to you............................................
24.
25.
25.
If line 21 is less than line 20, enter balance due.................................................................................................
26.
26.
If this return is fi led late, enter penalty and interest. (See instructions.) .............................................................
27.
27.
TOTAL PAYMENT DUE. Add lines 25 and 26. Make check payable to "State of Michigan." ..........................
* Use Tax on Items Purchased for Business or Personal Use: Use lines 14 and 15 to report purchases made for use in your business or
for items removed from your inventory for personal or business use. Do not repeat the amounts from Column A, lines 1 - 4 here.

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