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Michigan Department of Treasury (Rev. 03-22), Page 1
Schedule W
2022 MICHIGAN Withholding Tax Schedule
Issued under authority of Public Act 281 of 1967, as amended.
Type or print in blue or black ink. Attachment 13
INSTRUCTIONS: If you had Michigan income tax withheld in 2022, you must complete a Withholding Tax Schedule (Schedule W) to claim the
withholding on your Individual Income Tax Return (MI-1040, line 30). Report military pay in Table 1 and military retirement benefits and taxable railroad
retirement benefits (both Tier 1 and Tier 2) in Table 2 even if no Michigan tax was withheld. Include your completed Schedule W with Form MI-1040.
See complete instructions on page 2 of this form. If you need additional space, include another Schedule W.
1. Filer’s First Name M.I. Last Name 2. Filer’s Full Social Security No. (Example: 123-45-6789)
If a Joint Return, Spouse’s First Name M.I. Last Name 3. Spouse’s Full Social Security No. (Example: 123-45-6789)
TABLE 1: MICHIGAN TAX WITHHELD OR MILITARY PAY REPORTED ON W-2, W-2G or CORRECTED W-2 FORMS
A B C D E
Enter “X” for: Employer’s identification number Box 1 — Wages, tips, Box 17 — Michigan
Filer orSpouse (Example: 38-1234567) Box c — Employer’s name other compensation income tax withheld
00 00
00 00
00 00
00 00
00 00
Enter Table 1 Subtotal from additional Schedule W forms (if applicable). ...................................................... 00
4. SUBTOTAL. Enter total of Table 1, column E. ............................................................................... 4. 00
TABLE 2: MICHIGAN TAX WITHHELD OR MILITARY RETIREMENT BENEFITS AND RAILROAD RETIREMENT
BENEFITS (BOTH TIER 1 AND TIER 2) REPORTED ON 1099 FORMS
A B C D E
Enter “X” for: Payer’s federal identification Taxable pension distribution, Michigan income
Filer orSpouse number (Example: 38-1234567) Payer’s name misc. income, etc. (see inst.) tax withheld
00 00
00 00
00 00
00 00
00 00
Enter Table 2 Subtotal from additional Schedule W forms (if applicable). ...................................................... 00
5. SUBTOTAL. Enter total of Table 2, column E. ............................................................................... 5. 00
6. TOTAL. Add lines 4 and 5. Enter here and carry to MI-1040, line 30. ............................................ 6. 00
+ 0000 2022 57 01 27 5
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