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Michigan Department of Treasury
5095 (Rev. 04-20), Page 1 of 1
DO NOT FILE
2021 Sales, Use and Withholding Taxes Monthly/Quarterly
Reset Form
and Amended Monthly/Quarterly Worksheet
Business Account Number (FEIN or TR Number) Return Period (MM-YYYY)

PART 1: SALES AND USE TAX A. Sales B. Use: Sales & Rentals
1. Gross sales for tax period being reported. Carry amount from line 1A to
line 4A ...................................................................................................... 1.

2. Rentals of tangible property and accommodations ................................. 2.
XXXXXXX
3. Telecommunications services .................................................................. 3.
4. Total gross sales, rentals, accommodations and telecommunications XXXXXXX
services: Carry amount from line 4A to line 1a on Form 5080 or Form 5092.
Add lines 1B-3B and enter total on line 4B of this worksheet. Carry this
amount to line 1b on Form 5080 or Form 5092 ................................................ 4.

5. ALLOWABLE DEDUCTIONS A. Sales Tax B. Use Tax

a. Resale, sublease or subrent ............................................................. 5a.

b. Industrial processing exemption ....................................................... 5b.

c. Agricultural production exemption .................................................... 5c.

d. Interstate commerce ......................................................................... 5d.

e. Nontaxable services billed separately .............................................. 5e.

f. Bad debts ......................................................................................... 5f.

g. Food for human/home consumption ................................................. 5g.

h. Government exemption .................................................................... 5h.

i. Michigan motor fuel tax .................................................................... 5i.
XXXXXXX
j. Direct payment deduction ................................................................. 5j.

k. Other exemptions and/or deductions (see instructions) ................... 5k.

l. Tax included in gross sales............................................................... 5l.
XXXXXXX
m. Total allowable deductions. Add lines 5a - 5l .................................... 5m.

6. Taxable balance. Subtract line 5m from line 4 ......................................... 6.
7. Gross tax due: Multiply line 6 by 6% (0.06) and carry amount to lines
2a and 2b on Form 5080 or Form 5092................................................... 7.

PART 2: USE TAX ON ITEMS PURCHASED FOR BUSINESS OR PERSONAL USE

8. Purchases for which no tax was paid or inventory purchased or withdrawn for business or personal use .... 8.
9. Use tax on purchases due: Multiply line 8 by 6% (0.06) and carry to line 7 of Form 5080 or
Form 5092 ...................................................................................................................................................... 9.

IMPORTANT: Record the account number and return period at the top of the form. DO NOT FILE. Retain this worksheet in the business
records. This worksheet may be subject to audit.

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2021 Form 5095, Page 2 

     Instructions for 2021 Sales, Use and Withholding Taxes Monthly/Quarterly  
                       and Amended Monthly/Quarterly Worksheet (Form 5095) 

PART 1: SALES AND USE TAX                                       on exemption documentation, see  Revenue  Administrative 
Lines 1 through 3: For information about determining            Bulletin (RAB) 2016-14. 
whether a person has nexus with Michigan, see Revenue           Line 5a: Resale, Sublease or Subrent.  Enter resale, sublease 
Administrative Bulletins (RABs) 1999-1, 2015-22, and 2018-      or subrent exemption claims. 
16. Please also visit  www.michigan.gov/remotesellers for  
                                                                Line 5b: Industrial Processing Exemption. The sale 
guidance, including FAQs. 
                                                                or lease of tangible personal property ultimately used in 
Line 1A: Total Gross Sales for Tax Year.       This line should industrial processing by an industrial processor is exempt. 
be used by sellers with nexus to report sales of tangible       “Industrial processing” is the  activity of converting or 
personal property where ownership transfers in Michigan.        conditioning tangible personal  property by changing its 
This includes sellers with nexus through physical presence or   form, composition, quality, combination, or character. In 
economic presence (remote sales).                               general, all of the following must be met: 
Enter total sales, including cash, credit and installment         • Property  must be  used in producing a  product  for 
transactions, of tangible  personal  property. Include any          ultimate sale at retail, 
costs incurred before ownership of the property is transferred 
                                                                  • Property must be sold or leased to an “industrial 
to the buyer, including installation, shipping, handling, and 
                                                                    processor,”  including  a  person  that  performs industrial 
delivery charges. Dealers do not reduce sales reported here 
                                                                    processing on behalf of another industrial processor or 
by any trade-in value. 
                                                                    performs industrial processing on property that will be 
Providers of nontaxable services (that do not involve the sale      incorporated into a product for ultimate sale at retail, and 
or lease of tangible personal property) should not report those   • 
                                                                    Activity starts when property begins moving from raw 
sales. 
                                                                    materials storage to begin industrial processing and ends 
Line 1B: USE TAX - Total Sales for the Tax Year:         This       when finished goods first come to rest in finished goods 
line should be used by:                                             inventory. 
  •  Sellers with nexus to report sales of tangible personal    If property is used for both an exempt and a taxable purpose, 
     property sourced to Michigan, for which ownership          the property is only exempt to the extent that it is used for 
     transfers outside Michigan, or                             an exempt purpose. In such cases, the exemption is limited 
  •  Remote  sellers without nexus who voluntarily  collect     to the percentage of exempt use to total use determined by a 
     Michigan tax.                                              reasonable formula or method approved (but not required to 
                                                                be pre-approved) by Treasury. For exceptions and exclusions, 
Enter total sales, including cash, credit, and installment 
                                                                see MCL 205.54t and 205.94o. 
transactions, of tangible personal property. 
                                                                Line 5c:   Agricultural Production Exemption. Property 
Line 2B: USE TAX - Rental of Tangible Property and              must be directly or indirectly used in agricultural production. 
Accommodations.                                                 Generally, the following non-exhaustive list may be exempt: 
•      Lessors of tangible personal property: Lessors that have (i) Tangible personal property sold or leased to a person 
    made a valid election under MCL 205.95(4) and MAC R         engaged in a business enterprise that uses or consumes the 
    205.132(1) should report receipts from rentals of that      property for either: 
    tangible personal property under the election. 
                                                                  • Tilling, planting, draining, caring for, maintaining, or 
•     Persons providing accommodations: This includes but is 
                                                                    harvesting things of the soil, or 
    not limited to total hotel, motel, and vacation home 
    rentals, and assessments imposed under the Convention         • Breeding, raising,  or caring  for livestock, poultry,  or 
    and Tourism Act, the Convention Facility Development            horticultural products. 
    Act, the Regional  Tourism  Marketing Act, and the          (w)  To  the  extent  that  the  property  is affixed  to  and  made 
    Community Convention or Tourism Marketing Act.              a structural part of real estate for others and used for an 
Line 3B: USE TAX - Telecommunications Services.          Enter  exempt  purpose  in (i), tangible  personal  property sold to a 
gross income from telecommunications service.                   contractor that is one of the following: 
Line 5a-5l: Allowable Exemptions and/or Deductions. Use           • Agricultural land tile 
lines 5a - 5l to deduct from gross sales the nontaxable sales     • Subsurface irrigation pipe 
included in line 4. Deductions taken for tax exempt sales 
                                                                  • Portable grain bins 
must be substantiated in business records. A completed copy 
of Michigan Sales and Use Tax Certificate of Exemption            • Grain drying equipment and its fuel or energy source 
(Form  3372)  or  the  same  information  in  another  format   However, the following sales from (i) or (ii) are not exempt: 
must be obtained from the purchaser. For more information

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2021 Form 5095, Page 3

• Food, fuel, clothing, or similar property for personal in gross sales on line 1 and paid to the State or the distributor.
living or human consumption, or Line 5j: Direct Payment Deduction. Sales to companies
• Property permanently affixed to and becoming a that claim direct payment of sales or use tax to the State of
structural part of real estate unless it is agricultural land Michigan. Such companies must have a sales tax license
tile, subsurface irrigation pipe, a portable grain bin, or or use tax registration, and have a letter from Treasury
grain drying equipment. Certain property that can be specifically granting direct payment authority. For
disassembled and reassembled may be exempt. qualifications, see RAB 2000-3.
Some specific types of exempt property and exempt uses of Line 5k: Other Exemptions and/or Deductions: Identify
property are clarified in the statute. If property is used for exemptions or deductions not covered in items 5a through 5j
both an exempt and a taxable purpose, the property is only on this line. Examples of exemptions or deductions are:
exempt to the extent that it is used for an exempt purpose. • Allowable trade-in values on vehicle sales. Motor vehicle,
In such cases, the exemption is limited to the percentage of recreational vehicle, and watercraft dealers may be eligible
exempt use to total use determined by a reasonable formula to deduct the value of a trade-in under MCL 205.51(d).
or method approved (but not required to be pre-approved) Deduction for motor vehicles is subject to limitation.
by Treasury. For more information, see MCL 205.54a and Taxes paid to Secretary of State are not reported here.
205.94. Instead, they are reported on the Vehicle Dealer
Line 5d: Interstate Commerce. Enter sales made in Supplemental Schedule (Form 5086, e-file only).
interstate commerce. To claim such a deduction, the • Credit for the core charge attributable to a recycling fee,
property or service must be delivered by the business to the deposit, or disposal fee for a motor vehicle or recreational
out-of-state purchaser. Property transported out-of-state vehicle part or battery if the recycling fee, deposit, or
by the purchaser does not qualify as interstate commerce. disposal fee is separately stated on the invoice, bill of sale,
Documentation of out-of-state shipments must be retained in or similar document given to the purchaser.
business records to support this deduction.
• Direct sales, not for resale, to certain nonprofit agencies,
Line 5e: Nontaxable Services Billed Separately. Enter churches, schools, hospitals, and homes for the care of
charges for nontaxable services billed separately, such as children and the aged, to the extent the property is used to
repair or maintenance, if these charges were included in carry out the nonprofit purpose of the organization. For
gross receipts on line 1. Costs, such as delivery or installation sales to certain nonprofit agencies, the exemption is
charges, that are incurred before the completion of the limited based on the sales price of property used to raise
transfer of ownership of taxable property are included in the funds or obtain resources. All sales must be paid for
tax base and may not be subtracted. directly from the funds of the exempt organization to
Line 5f: Bad Debts. Bad debts may be eligible for a qualify.
deduction if the following criteria are met: • Assessments imposed under the Convention and Tourism
• The debts are charged off as uncollectible on business Act, the Convention Facility Development Act, the
books and records at the time the debts become worthless Regional Tourism Marketing Act, or the Community
Convention or Tourism Marketing Act. Hotels and motels
• The debts are deducted on the return for the period during
may deduct the assessments included in gross sales and
which the bad debts are written off as uncollectible
rentals provided use tax on the assessments was not
• The debts are eligible to be deducted for federal income charged to the customers.
tax purposes. • Credits allowed to customers for sales tax originally paid
A bad debt deduction may also be claimed by a third-party on merchandise voluntarily returned, provided the return
lender provided the retailer who reported the tax and the is made within the time period for returns stated in the
lender financing the sale executed and maintained a separate taxpayer’s refund policy or 180 days after the initial sale,
written election designating which party may claim the whichever is earlier. Repossessions are not allowable
deduction. Certain additional conditions must be met. See deductions.
MCL 205.54i, 205.99a, and RAB 2015-27. • Sales to contractors of materials which will become part
Line 5g: Food for Human/Home Consumption. Enter the of a finished structure for a qualified exempt nonprofit
total of retail sales of grocery-type food, excluding tobacco, hospital, qualified exempt nonprofit housing entity or
marihuana products, and alcoholic beverages. Prepared food church sanctuary, or materials to be affixed to and made a
is subject to tax. See MCL 205.54g and MCL 205.94d for structural part of real estate located in another state. The
more information. purchaser will provide a Michigan Sales and Use Tax
Contractor Eligibility Statement (Form 3520). See RAB
Line 5h: Government Exemption. Direct sales to the
1999-2.
United States Government, State of Michigan, or its political
subdivisions are exempt. • Vehicle sales to non-reciprocal states for which no tax was
paid to Secretary of State.
Line 5i: Michigan Motor Fuel Tax. Motor fuel retailers
may deduct the Michigan motor fuel taxes that were included • Qualified nonprofit organizations with aggregate sales in

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2021 Form 5095, Page 4 

the calendar year of less than $25,000 may exempt the           PART 2: USE TAX ON ITEMS PURCHASED FOR 
first $10,000 of sales for fundraising purposes. Separately,    BUSINESS OR PERSONAL USE 
veterans organizations exempt under IRC 501(c)(19) may          Line 8: Enter purchases for which no tax was paid, including 
exempt  sales for  the  purpose  of  raising  funds for the     property withdrawn from inventory for business or personal 
benefit of an active duty service member or veteran, up to      use. For Manufacturer/Contractors, alternative measures of 
$25,000 per event.                                              the use tax base should be reported (see MCL 205.93a(1)(f) 
Line 5l: Tax Included in Gross Sales. Complete this line        and (g) and RAB 2016-24 for more information). For all other 
only if you have tax included in your gross sales. Subtract the taxpayers, report the “purchase price” as defined in MCL 
sum of lines 5a through 5k from line 4. Divide the result by    205.92(f). 
17.6667 and enter on line 5l.

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