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Michigan Department of Treasury 
3423 (Rev. 11-21), Page 1 of 2 

2021 MICHIGAN Schedule 1 Additions and Subtractions      
Issued under authority of Public Act 281 of 1967, as amended. 
  
Include with Form MI-1040. Type or print in blue or black ink.                                                                                    Attachment 01
Filer’s First Name                   M.I.    Last Name                              Filer’s Full Social Security No. (Example: 123-45-6789) 

Additions to Income (all entries must be positive numbers) 
  1.  Gross interest and dividends from obligations issued by states 
      (other than Michigan) or their political subdivisions.....................................................................              1.  00 
  2.  Deduction for taxes on or measured by income, including self-employment tax, taken on your  
      federal return, and allocated share of tax paid by an electing flow-through entity (see instructions)                                   2.  00 

  3.  Gains from Michigan column of MI-1040D and MI-4797  .............................................................                       3.  00 

  4.  Losses attributable to other states (see instructions)  ..................................................................              4.  00 

  5.  Net loss from federal column of your Michigan MI-1040D or MI-4797 ........................................                              5.  00 
  6.  Oil, gas, and nonferrous metallic mineral expenses (Michigan sourced) deducted to arrive at 
      Adjusted Gross Income (AGI)......................................................................................................       6.  00 

  7.  Federal Net Operating Loss deduction included in AGI...............................................................                     7.  00 

  8.  Other (see instructions). Describe: ___________________________________________                                                         8.  00 

  9.  Total additions. Add lines 1 through 8. Enter here and on MI-1040, line 11   .........................                                  9.  00 

Subtractions from Income (all entries must be positive numbers) 
  10.  Income from U.S. government bonds and other U.S. obligations included in MI-1040, line 10. 
      Include U.S. Schedule B if over $5,000.......................................................................................     10.       00 
  11. Amount included in MI-1040, line 10, from military retirement benefits due to service in the 
      U.S. Armed Forces or Michigan National Guard, or taxable railroad retirement benefits  .............  11.                                   00 

  12.  Gains from federal column of Michigan MI-1040D and MI-4797  .................................................  12.                         00 

  13.  Income attributable to another state. Explain type and source:________________________                                           13.       00 

  14. Taxable Social Security benefits or military pay (not retirement) included on MI-1040, line 10  ..                                14.       00 

  15.  Income earned while a resident of a Renaissance Zone (see instructions). ...............................  15.                              00 
  16.  Michigan state and local income tax refunds received in 2021 and included 
      on MI-1040, line 10 (see instructions)  .........................................................................................  16.      00 
  17.  Michigan Education Savings Program, MI 529 Advisor Plan, and Michigan Achieving a Better 
      Life Experience Program.  ............................................................................................................  17. 00 

  18.  Michigan Education Trust . ..........................................................................................................  18. 00 

  19.  Oil, gas, and nonferrous metallic minerals income (Michigan sourced) included in AGI  .............  19.                                   00 
  20.  Resident Tribal Member income exempted under a State/Tribal tax agreement or 
      pursuant to Revenue Administrative Bulletin 1988-47   .................................................................  20.                00 

  21.  Miscellaneous subtractions (see instructions). Describe:______________________________  21.                                                00 

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2021 Form 3423, Page 2 of 2 

2021 MICHIGAN Schedule 1 Additions and Subtractions                    
Filer’s First Name                   M.I.      Last Name                                         Filer’s Full Social Security No. (Example: 123-45-6789) 

Deduction Based on Year of Birth 
Complete  22A      through  22H  if  claiming  the  Michigan  Standard  Deduction,  the  retirement  benefits  deduction  or  the  senior  investment  
income deduction on lines 23, 24, 25, or 26. Check box(es) 22C and/or 22G only  if you or your spouse received retirement benefits from  
employment with a governmental agency not covered by the federal Social Security Act (SSA exempt employment). See instructions  
before continuing. 
22.                                  FILER                                                                                                SPOUSE 
          A.                B.                  C.                 D.              E.            F.                                                G.                       H. 
                            Age      Check if filer                Check if filer  Year of Birth Age                                          Check if spouse               Check if spouse 
    Year of Birth                    received benefits SSA exempt  retired as of   (19xx)        as of                                        received benefits SSA exempt  retired as of 
    (19xx)                  as of    from                          01-01-2013 and                                                             from                          01-01-2013 and 
                     12-31-2021      employment                    born after 1952                12-31-2021                                  employment                    born after 1952 

23. Tier 2 Michigan Standard Deduction. Complete this line if the older of you or your spouse 
    (if married) was born during the period January 1, 1946 through December 31, 1952, and 
    reached age 67. Do not complete lines 24, 25 or 26................................................................                    23.                                        00 
24. Tier 3 Michigan Standard Deduction. Complete this line if the older of you or your spouse  
    (if married) was born during the period January 1, 1953 through January 1, 1955, and reached 
    age 67 on or before December 31, 2021. Do not complete lines 23, 25 or 26. Enter amount 
    from line 6 of Worksheet 2........................................................................................................... 24.                                        00 
25. Retirement benefits. Enter amount from line 16, 17 or 18 of Form 4884, Michigan Pension 
    Schedule.   Include Form 4884  ...................................................................................................    25.                                        00 
26.  Dividend/interest/capital gains deduction for taxpayers 76 years and older. Deduction is 
    limited to $12,127 for single or married filing separately filers and $24,254 for joint filers, less 
    any deduction for retirement benefits (see instructions).  .............................................................              26.                                        00 
    Check this box if you are the unremarried surviving spouse claiming a dividend, interest or capital  
    gains deduction for someone born before 1946 who was at least age 65 at the time of death. 

27. Subtotal. Add lines 10 through 26 ..............................................................................................  27.                                            00 
28. 2021 Michigan NOL Deduction. Enter amount from line 11 or 12 of Form 5674, Michigan Net 
    Operating Loss Deduction. Include Form 5674  .........................................................................  28.                                                      00 

29. Total Subtractions. Add lines 27 and 28. Enter here and on MI-1040, line 13 ..........................  29.                                                                      00 

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