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Michigan Department of Treasury                                                                                                                                           Attachment 27 
4974 (Rev. 04-22) 

2022 MICHIGAN Schedule of Corporate Income Tax Liability 
for a Michigan Business Tax Insurance Filer 
Issued under authority of Public Act 36 of 2007 and PA 39 of 2011. 
Taxpayer Name (print or type)                                                            Federal Employer Identification Number (FEIN) 

PART   1: CERTIFICATED          NONREFUNDABLE CREDITS                      

 1.  Tax Before Nonrefundable Credits from Form 4588, line 23  .............................................................................                          1.  00 

 2.  Noncertificated nonrefundable credits (see instructions)...................................................................................                      2.  00 

 3.  Tax After noncertificated nonrefundable credits. Subtract line 2 from line 1. If less than zero, enter zero  ........                                            3.  00 

 4.  Available Renaissance Zone Credit (see instructions)  ......................................................................................                     4.  00 

 5.  Renaissance Zone Credit. Enter lesser of line 3 or 4 ........................................................................................                    5.  00 

 6.  Tax After Renaissance Zone Credit. Subtract line 5 from line 3  ........................................................................                         6.  00 
 7.  Available Historic Preservation Credit Net of Recapture from Form 4596, line 18b. If negative, enter as a 
     negative number ................................................................................................................................................ 7.  00 

 8.  Historic Preservation Credit Net of Recapture. Enter lesser of line 6 or 7.........................................................                              8.  00 

 9.  Tax After Historic Preservation Credit Net of Recapture. Subtract line 8 from line 6 .........................................                                   9.  00 

10.  Available Brownfield Redevelopment Credit from Form 4596, line 20  ..............................................................  10.                               00 

 11. Brownfield Redevelopment Credit. Enter lesser of line 9 or 10 .........................................................................                          11. 00 

12.  Tax After Brownfield Redevelopment Credit. Subtract line 11 from line 9  .........................................................  12.                              00 

13.  Film Infrastructure Credit from Form 4596, line 25 ............................................................................................  13.                 00 

14.  Certificated Nonrefundable Credits for CIT. Add lines 5, 8, 11, and 13  .............................................................  14.                           00 

PART   2: CIT     LIABILITY 

15.  Enter amount from Worksheet A, line 24 (see instructions)  ..............................................................................  15.                       00 

16.  CIT  After Certificated Nonrefundable Credits. Subtract line 14 from line 15  .....................................................  16.                             00 

17.  Total Recapture of Certain Business Tax Credits for CIT from Form 4588, line 26  ...........................................  17.                                    00 

18.  CIT  After Recapture. Add lines 16 and 17 .........................................................................................................  18.             00 

PART   3: MBT     TAX COMPARED          AGAINST CIT FOR INSURANCE FILERS                  

19.  Total MBT liability from Form 4588, line 27  .......................................................................................................  19.            00 
20.  If line 18 is greater than line 19, enter the difference. If line 19 is greater than or equal to line 18, enter zero. 
     Carry to Form 4588, line 28 ...............................................................................................................................  20.     00 

+ 0000 2022 62 01 27 4 



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                                                                              Instructions for Form 4974 
                                                         Schedule of Corporate Income Tax Liability 
                                                    for a Michigan Business Tax Insurance Filer 
                                                                                                             the checkbox        on  line              2 of Form 4595.      Enter       credit   amount         from   
Purpose 
                                                                                                             Form        4595,  line  25b,  for which             certificated         status            is properly  
The purpose              of this form                 is to determine the       Corporate  Income            claimed on       Form    4595,        line    2.   
Tax   (CIT)     liability                of an  insurance  company that              files   under         
the    Michigan  Business Tax                    (MBT).        The    CIT      liability  will               If      a taxpayer has    activity          in more      than one         certificated                    
be  compared  against the                   MBT     liability              in order      to determine        Renaissance Zone,                  a separate Form           4595    will     be    filed    for   each   
which  liability      is greater.                                                                            Zone.       In  that  case, report         here    the  combined           total               of credits  
                                                                                                             claimed      on  all Forms          4595,     line    25b,    for   which       certificated              
NOTE:              A credit      or recapture            should  not be        reported     on  this         status      is properly claimed             on    Form    4595,    line     2.   
form              if it is not  reported  on  one      of the  following  forms: 
                                                                                                             DO  NOT  use  the Renaissance                     Zone      credit  amount          from    Form          
  • Miscellaneous Credits for Insurance Companies                                              (Form         4573      or Form 4596             to complete this       line.    
4596). 
                                                                                                             Line 6: Subtract  line                   5 from    line      3 and  enter       amount      in field.  
  • Schedule of Recapture of Certain Business Tax Credits and 
                                                                                                             This      figure  represents the            MBT      liability    after      applying       the           
Deductions  (Form  4587). 
                                                                                                             Renaissance Zone           Credit.          
NOTE:  Beginning  January      1, 2012,  only  those  taxpayers  with  
   a certificated  credit,  which      is awarded  but  not  yet  fully  claimed                             Line 9:                                                                                                     
                                                                                                                          Subtract line            8 from       line   6 and     enter       amount   in field. 
                                                                                                             This      figure  represents the            MBT      liability    after      applying       the           
or  utilized,  may  elect          to be MBT  taxpayers. 
                                                                                                             Historic Preservation            Credit        Net         of Recapture. 
Line-by-Line Instructions                                                                                                  Subtract line               11 from line         9 and enter      amount            in field.  
                                                                                                             Line 12: 
Lines not      listed          are  explained       on    the  form.                                         This      figure  represents the            MBT      liability    after      applying       the           
Enter the      taxpayer’s            name      and        Federal   Employer         Identification          Brownfield                                                
                                                                                                                              Redevelopment Credit.
Number  (FEIN)   the   in              appropriate           field.                                          Line 14: Add lines                         5, 8, 11 and 13.  This         is the total    amount        of   
                                                                                                             Certificated Nonrefundable                    Credits     for   CIT.       
PART 1: CERTIFICATED NONREFUNDABLE CREDITS 
Line 2:        Combine the               total   amount        of noncertificated                            PART 2: CIT LIABILITY 
nonrefundable                  credits from      Form       4596,    line  6, and      the                   Line 15: Effective with                tax    years     beginning               in 2019, Public     Act   
amounts        from  Form 4596,                 lines    13  and     15.   Enter    the total                222      of 2018 amends         MCL         206.635,      which      alters      the   tax   liability    
combined  amount,      as this represents                      the   allowable       amount      of          calculation          of a Corporate              Income       Tax   (CIT)  filer.  Beginning              
noncertificated  nonrefundable  credits.                                                                     Jan.      1, 2019,  for      a CIT     filer,    gross    direct    premiums  attributable                
Line 3: Subtract  line   from   2                  line     less     1. If than  zero,   enter   zero.       to                                                                                                       
                                                                                                                qualified health insurance premiums are taxed   at 0.95%. The 
This       is the  MBT         liability  after  noncertificated nonrefundable                               remaining                                                                                  
                                                                                                                              portion   of the tax base   is still taxed   at 1.25%.
credits.                                                                                                     To   calculate  CIT  tax liability               for   the   purpose         of completing                
Line       4:      Not                all   Renaissance                   Zone       credits          are    Form                                                                                                     
                                                                                                                         4974, the taxpayer             must    complete       the “Michigan                          
certificated       credits       tobe reported              on  this  form.      See   special               Business                                                                                                    
                                                                                                                            Tax    Insurance Worksheet                   A”   in these       instructions.            
                                                                                                             Carry  the  amount from               Worksheet          A,    line  24,              to Form     4974,  
instructions       on  the            MBT Renaissance  Zone  Credit Schedule 
(Form      4595)   to determine                 which       Renaissance        Zone    credits               line         
                                                                                                                   15.
are    certificated.      A certificated Renaissance                       Zone     credit  will             Include      a copy      of Worksheet      A with the             MBT         return.     
be  identified  by  the checkbox                    on   line   2          of Form 4595.  Only       a       
credit      ofthat type        may    be  reported          here.  Enter      credit  amount                 Line 16:                                                                                                
                                                                                                                           Subtract line 14             from    line   15.    This           is the   amount   of
from       Form  4595, line           25b,      for      which  certificated        status   is              the                                                                                                
                                                                                                                 CIT liability after Certificated Nonrefundable Credits.
properly claimed                on   Form    4595,        line  2.                                           Line 18:  Add  lines 16               and     17.  This                is the  amount of          CIT     
If       a taxpayer  has activity               in  more    than  one certificated                           liability                                                                                             
                                                                                                                          after the Recapture   of Certain Business Tax Credits.
Renaissance  Zone,   separate   a                    Form     4595     will     be   filed   for  each       PART 3: MBT TAX COMPARED AGAINST CIT FOR 
Zone.      In  that  case, report           here    the     combined          total  of credits              INSURANCE FILERS 
claimed      on  all Forms            4595,      line    25b,   for   which        certificated              Line 20:        Carry  the amount                on  this   line  to the                  Insurance 
status       is properly claimed             on   Form       4595,    line     2.                            Company  Annual  Return for Michigan Business and 
DO NOT use the                  Renaissance               Zone  credit      amount      from    Form         Retaliatory Taxes (Form 4588),                      line     28.   This     amount             is used   to   
4596   complete   to            this   form.                                                                 calculate the      tax  liability         for       an MBT filer.     
Enter      the  available             Certificated   Renaissance  Zone Credit.                               Include completed Form 4596 as part of the tax return filing.                                           
Not  all  Renaissance Zone                  credits      are   certificated         credits  to      be    
reported  on  this form.              See     special       instructions       on   Form    4595           
to  determine  which Renaissance                         Zone    credits       are  certificated.          
       A certificated          Renaissance          Zone    credit    will  be identified            by    

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Michigan Department of Treasury 
MBT Insurance Worksheet A (Rev. 04-22) 

2022 Michigan Business Tax Insurance Worksheet A 

Include a copy of Worksheet A with your MBT return. 
Taxpayer Name                                                                                                              Federal Employer Identification Number (FEIN) 

DIRECT PREMIUMS WRITTEN IN MICHIGAN                                                                                                         A                             B 
                                                                                                                               Qualified Health Ins. Policies             All Other Policies 
1.  Gross direct premiums written in Michigan................................................................              1.                                 00                             00 
2.  Premiums on policies not taken.................................................................................        2.                                 00                             00 
3.  Returned premiums on canceled policies..................................................................               3.                                 00                             00 
4.  Receipts on sales of annuities ...................................................................................     4.                                 00                             00 
5.  Receipts on reinsurance assumed (see instructions) ................................................                    5.                                 00                             00 
6.  Add lines 2 through 5................................................................................................. 6.                                 00                             00 
7.   Direct Premiums Written in Michigan.  Subtract line 6 from line 1.  
     If less than zero, enter zero ....................................................................................... 7.                                 00                             00 
DISABILITY INSURANCE EXEMPTION 
8.  Disability insurance premiums written in Michigan, not including credit or disability  
     income insurance premiums (see instructions) ...........................................................              8.                                 00                             00 
9.  Proportional share of limit and phase-out. 
     Column A: Divide line 8, column A, by the sum of line 8, columns A and B. 
     Column B: Divide line 8, column B, by the sum of line 8, columns A and B.............                                 9.                                 %                              % 
10.  Enter the sum of all disability insurance premiums from both columns of line 8  
     OR $190,000,000, whichever is less  ...............................................................................................  10.                             00 
11.  Gross direct premiums from insurance carrier services everywhere...............................................  11.                                                 00 
12.  Phase out  ........................................................................................................................................  12. 280,000,000 00 
13.  Subtract line 12 from line 11. If less than zero, enter zero  ..............................................................  13.                                    00 
14.  Exemption reduction. Multiply line 13 by 2 ......................................................................................  14.                               00 
15.  Subtract line 14 from line 10. If less than zero, enter zero ..............................................................  15.                                     00 
16.  Allocated reduced exemption. 
     Column A: Multiply line 15 by the percentage on line 9, column A. 
     Column B: Multiply line 15 by the percentage on line 9, column B .........................  16.                                                          00                             00 
17.  Adjusted tax base. 
     Column A: Subtract line 16, column A, from line 7, column A. 
     Column B: Subtract line 16, column B, from line 7, column B.................................  17.                                                        00                             00 
18.  Multiply line 17, column A, by 0.9391% and column B by 1.25% (0.0125) ....................                            18.                                00                             00 
19.  Tax before credits. Add line 18, columns A and B............................................................................  19.                                    00 
CREDITS 
20.  Enter amounts paid from 1/1/2021 to 12/31/2021 to each of the following: 
     a.  Michigan Workers’ Compensation Placement Facility .....................................................................................  20a.                                       00 
     b.  Michigan Basic Property Insurance Association ..............................................................................................  20b.                                  00 
     c.  Michigan Automobile Insurance Placement Facility  ........................................................................................  20c.                                    00 
     d.  Property and Casualty Guaranty Association ..................................................................................................  20d.                                 00 
     e.  Michigan Life and Health Insurance Guaranty Association  .............................................................................  20e.                                        00 
21.  Add lines 20a through 20e......................................................................................................................................  21.                    00 
22.  Michigan Examination Fees or Regulatory Fee......................................................................................................  22.                                  00 
23.  Credit. Multiply line 22 by 50% (0.50) .....................................................................................................................  23.                       00 
24.  Tax liability before recapture. Subtract line 21 and line 23 from line 19. If less than or equal to $100, enter zero. 
     Carry amount to Form 4974, line 15 .......................................................................................................................  24.                         00 



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                Instructions for the  Michigan Business Tax Insurance Worksheet A 
Purpose                                                                                                            The   exclusion  for disability        insurance     premiums        does  not          
                                                                                                                   include   credit insurance       or    disability  income        insurance              
To  calculate      a Corporate            Income          Tax  liability  for the            purpose               premiums. 
of completing       the    “Schedule               of Corporate Income              Tax         Liability       
for      a Michigan Business            Tax   Insurance            Filer”     (Form        4974).                  CREDITS 
                                                                                                                   Line 20:      Enter the amounts        paid     to the listed      facilities           
Line-by-Line Instructions 
                                                                                                                   or  associations from     January      1, 2021,     to December         31,                
Lines not     listed   are   explained           on     the     form.                                              2021,  including special assessments.              Net the       amounts   paid         
Enter the     taxpayer’s        name       and    Federal          Employer         Identification                 and  refunds received during           20       21  for the same     facility  or       
Number       (FEIN)  used on           the   “Insurance             Company           Annual                       association.       If refunds    received       exceed the     amount  paid      thein  
Return     for  Michigan  Business and                    Retaliatory          Taxes”          (Form               year for  the  same       facility   association,   or enter       zero. 
4588).                                                                                                             Line 20c: For tax        years    beginning      on  and  after      January   2021   1,  
Direct Premiums Written in Michigan                                                                                amounts  paid   the   to   Michigan     Automobile         Insurance  Placement  
                                                                                                                   Facility   (MAIPF)  that  are attributable           to      the assigned  claims       
NOTE: For  line 1 through line 9 and line  16 through 
                                                                                                                   plan shall   not      beincluded in      the  calculation      thisof  credit. 
line  18,  complete  Column  A  to  report  Qualified  Health 
Insurance  Policies and Column B  to report  all  other                                                            Line 22:    Enter  the amount      of      Michigan Examination           Fees    or      
policies.                                                                                                          Regulatory Fees         paid   2022   in (under     Michigan         Compiled       Law  
“Qualified health          insurance          policies”         means      policies        written        on       500.224). 
risk located          or residing      in this state            that  are           1 of the following             Line 24: Carry the         amount   from        Worksheet   line   A,     24,   Form   to  
types      of policies:                                                                                            4974, line   15.   Include      acopy      ofWorksheet A   with       your   return.  
         (a) Comprehensive  major  medical, regardless                                          of whether 
         the  policy           is eligible  for              a health  savings account                or         
         purchased on        the     health      insurance          marketplace.             
         (b) Student. 
         (c) Children’s health             insurance            program.      
         (d) Medicaid. 
         (e)  Employer comprehensive,                          regardless      of whether                      
         the  policy           is eligible  for              a health  savings account                or       
         purchased on        the     health      insurance          marketplace.             
         (f) Multiple employer                associations                or trusts and      any      other    
         employer associations                and    trusts. 
Qualified Health          Insurance           Policies          are  taxed             at a special rate,       
determined annually                 using   a   statutory       formula.           
Line 1: Enter all         gross      direct      premiums            written        on  property              or   
risk located         or residing      in Michigan. 
Line 2:  Enter  premiums on                  policies          not   taken     to  the  extent                    
these premiums         were         included      in line 1.   
Line 3:  Enter  returned  premiums on                          canceled        policies                  to the  
extent these     premiums            were     included               in line 1.   
Line 4: Enter receipts               on    sales         of annuities      to the extent              these       
receipts were     included                in line 1.   
Line 5:  Enter  receipts  on reinsurance                       premiums            assumed                    to   
the extent     these   receipts      were        included             in line      1, and only             if tax  
was paid     on  the   original      premiums.             
DISABILITY INSURANCE EXEMPTION 
Line 8: “Disability insurance”                      includes          any     policy            or contract  
of insurance     against     loss       resulting       from       sickness              or from bodily         
injury      or death by    accident,               or both, including         also     the      granting        
of   specific  hospital benefits             and       medical,         surgical      and    sick-  
care benefits          to any person,         family            or group, subject                 to certain  
exclusions. 

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