Form Mi-1041 - Michigan Fiduciary Income Tax Return - 2011 Page 2
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42011 MI-1041, Page 2
SCHEDULE 1: NET MICHIGAN ADJUSTMENT FOR RESIDENT ESTATES OR TRUSTS
Additions
34. Gross interest and dividends from obligations issued
by states other than Michigan or their political subdivisions .........................
34.
00
35. Taxes imposed on or measured by income deducted on U.S. Form 1041 ...
35.
00
36. Expenses included in U.S. Form 1041
attributable to income from sources outside of Michigan
36.
00
......................................
37. Expenses and interest incurred in production of
income from U.S. government obligations on U.S. Form 1041 ....................
37.
00
38. Other (attach schedule)
38.
00
.......................................................................................................
39. Total additions. Add lines 34 through 38 .............................................................................................
39.
00
Subtractions
40. Income from U.S. government bonds and other
obligations to the extent included in federal taxable income ........................
40.
00
41. Income attributable to another state. Explain type and source: _________
__________________________________________________________
41.
00
42. Expenses related to obligations of other states not deducted on U.S. Form 1041
42.
00
43. Other (attach schedule) ................................................................................
43.
00
44. Total subtractions. Add lines 40 through 43 ........................................................................................
44.
00
45. Net Michigan adjustment. Subtract line 44 from line 39 and enter here .............................................
45.
00
If no distribution to beneficiaries, carry this amount to page 1, Part 2, line 9.
Otherwise complete Schedules 2 and 3.
SCHEDULE 2: NAMES AND ADDRESSES OF BENEFICIARIES. Complete if any income is distributed.
Address of each beneficiary. If mailing
Social Security number or FEIN
Name of each beneficiary
of each beneficiary
address differs from home address, give both.
46a.
46b.
46c.
46d.
SIGNATURES AND DECLARATIONS
I declare under penalty of perjury that the information in this return and attachments is true and
I declare under penalty of perjury that this return is based on all
complete to the best of my knowledge.
information of which I have any knowledge.
Signature of Fiduciary or Officer Representing Fiduciary
Date
Preparer’s Name, Address, PTIN and/or FEIN
I authorize Treasury to discuss my return with my preparer.
Yes
No
This return is due April 17, 2012, or on the 15th day of the fourth month after the close of your tax year.
WITH PAYMENT: Pay amount on line 30. Mail
Make check payable to “State of Michigan”
WITHOUT PAYMENT: Mail return to:
and write the estate’s or trust’s FEIN and
check and return to:
“2011 MI-1041” on the front of the check.
Michigan Department of Treasury
Michigan Department of Treasury
P.O. Box 30058
Department 781041
Lansing, MI 48909
P.O. Box 78000
Detroit, MI 48278-1041
Continued on page 3.
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