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          Corporate 

Income Tax 

INSURANCE COMPANIES 

          This booklet contains information 
                   on completing a Michigan    
            Corporate Income Tax return for    
                      calendar year 2022. 

   E-filing  your  return      is easy,  fast, and       secure!  

    Visit  Treasury’s  Web  site      at             
www.MIfastfile.org  for      a    list   e-file   of       
resources  and  how      tofind an   e-file             
provider. 

WWW.MIFASTFILE.ORG 

            FILING DUE DATE:                                       

ALL FILERS — ON OR BEFORE                                           

                      MARCH 1, 2023 

          WWW.MICHIGAN.GOV/TAXES 
This booklet is intended as a guide to help complete your return. It does not take the place of the law.              MICHIGAN 2022
Michigan Department of Treasury — 4904 (Rev. 12-22) 



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                                  2022 General Information for Insurance Companies 
Standard Taxpayers and Financial Institutions:   See the Michigan Business Tax (MBT) Instruction Booklet for Standard Taxpayers  
               (Form 4600) or the MBT Instruction Booklet for Financial Institutions (Form 4599) at www.michigan.gov/taxes. 
This booklet is intended as a guide to help complete the CIT                                     •    The     first  $190,000,000 of             disability        insurance         premiums             
return. It does not take the place of the law.                                                        written       in  Michigan. This           exemption                      is reduced  by two        
                                                                                                      dollars  for  every  dollar  that  an  insurance  company’s  gross  
Who Files an Insurance Return?                                                                        direct     premiums  everywhere (both                     within        and    outside    of        
All   insurance companies,           except   those  authorized      under                            Michigan)  exceed  $280,000,000. 
chapter    46  or 47  of    the  insurance     code  of 1956,        that are                            insurance  company                is subject      to tax  as  calculated under                   
                                                                                               An
engaged   in  the business        of    writing,  or that    are authorized                             CIT      or the      retaliatory  tax  under Michigan                   Compiled        Law       
                                                                                               the
to   write,  insurance or       surety   contracts   within   the State      of                               500.476a,  whichever is              greater.        The      tax imposed                   
                                                                                               (MCL)
Michigan       file  the      Insurance Company Annual Return for                              under  the  Income Tax               Act               is in lieu      of all  other     privilege  and    
Corporate Income and Retaliatory Taxes (Form 4905).                                                             fees      or taxes,        except  for  real and            personal      property        
                                                                                               franchise
An    insurance company             is  defined to   mean    an  authorized                    taxes  and  sales  and  use  taxes. 
insurer    as  defined in       section   108  of  the  insurance    code    of               
                                                                                               Filing CIT Quarterly Tax Estimates for 2022 
1956,      1956  PA  218,  MCL 500.108.              Public  Act 276 of 2016 
amended  the  insurance  code  effective  July  1,  2016,  which                                      If estimated        liability  for    the  year      is reasonably expected                  to     
now includes a health maintenance organization (HMO)                                           exceed  $800,   taxpayer   a           must        file    estimated          returns.   taxpayer   A      
as an  “insurer.” If an  HMO is  an  “authorized” “insurer”                                    may   remit  quarterly estimated                  payments             by  check         with  a             
under  the  insurance  code,  is  not  otherwise  exempt  from                                 Corporate Income Tax Quarterly Return                                      (Form  4913)      or may        
tax, that HMO is required to file a CIT insurance return.                                      remit   monthly      or quarterly estimated                     payments            electronically         
In  the  case  that  an  HMO  would  file          as a CIT  standard  taxpayer                by  Electronic  Funds  Transfer  (EFT).  When  payments  are  made  
for      a federal  tax  year that   straddles    PA    276’s  effective     date,             by  EFT,  Form  4913      notis               required. 
two  short-year  returns  (one  short-year  standard  return  and  one  
insurance  return)  will      be required  for  that  year.                                    NOTE:                                                                                                     
                                                                                                               Formerly, taxpayers could pay by check on a   monthly                                     
                                                                                               or   quarterly  basis by            remitting     a check           with     a Combined                    
All  insurers,  domestic and         foreign,   must    submit    copies               of the  Return  for  Michigan  Tax  (Form  160).  Form  160  was  replaced.  
Michigan Business          Page        of Schedule      T when filing  this   return.          The   new  form no             longer       accommodates             CIT       payments.       As          
                                                                                                  a result,      Form         4913      is the only      form   that      supports       a CIT            
Using This Booklet                                                                             estimated  payment. 
This     CIT  booklet includes          forms  and   instructions    for all                   Estimated  returns  and  payments  for  calendar  year  taxpayers  are  
insurance   filers.  Read the        General    Information       first.               It is   due      Treasuryto             by  April  15,  July  15,  October  15,  and  January  
recommended that           taxpayers       and  tax  preparers     also    review      the     15      ofthe following        year.  The     sum     of estimated             payments       for          
instructions for      all  forms.                                                              each  quarter  must always                  reasonably        approximate              the   liability     
There are     both    nonrefundable         and  refundable  credits  available                for the      quarter.     
for  insurance  companies      to help  reduce  the  calculation      of tax.                  NOTE:          Your        debit  transaction will            be    ineligible        for EFT              
The   Michigan Association              and  Facilities   Credit     and the                          if the  bank      account     used    for  the     electronic  debit      is funded or      
Michigan  Examination  Fees  Credit  are  claimed  on  Form  4905.                             otherwise  associated  with a      foreign account                           to      the extent  that      
In   addition,  the Workers’         Disability    Supplemental       Benefit                  the payment              transaction   would        qualify     International     as an            ACH     
(WDSB)  Credit          is a refundable         credit  that      is also  claimed  on         Transaction (IAT)               under  NACHA               Rules.       Contact        your   financial    
Form   4905.  When claiming              the  WDSB      Credit   the  taxpayer                 institution           for  questions about        the     status       of your        account.             
will  need      to attach  the  document  provided  by  the  grantor      to the               Contact        the  Michigan Department                      of  Treasury’s           (Treasury)           
return      to substantiate  the  claim      of this  credit.                                  Business        Tax      Customer Service             Center        at      517-636-6925 for               
                                                                                               alternate payment               methods.      
Overview of CIT for Insurance Companies                                                        The  estimated  payment made                      with    each      quarterly         return   must        
The  CIT  imposes             a tax  on  insurance  companies equal                  to 1.25   be  computed  on  the  actual  CIT for                     the     quarter,      25or        percent      of
percent      of gross   direct  premiums written          on  property               or risk   the estimated             total  liability.   
located      in Michigan.  There      is no  filing  threshold  for  insurance                 To avoid        interest       and   penalty     charges,         estimated          payments      must    
companies.                                                                                     equal       at least       85   percent      of the  total liability           for    the  tax   year      
Direct  premiums  do  not  include:                                                            and   the  amount  of each            estimated           payment           must      reasonably           
                                                                                               approximate the                tax  liability    for  that      quarter.   the   If        prior  year’s   
  • Premiums  on  policies  not  taken                                                         tax  under  the Income              Tax      Act  was     $20,000           or      less, estimated        
  • Returned  premiums  on  canceled  policies                                                 tax may         be      based  on  the prior      year’s      total          tax  liability paid       in      
  • Receipts  from  the  sale      of annuities                                                four      equal  installments. (“Four               equal       installments”             describes        
                                                                                               the   minimum  pace of               payments        that     will     satisfy      this safe              
  • Receipts  on  reinsurance  premiums      if the  tax  had  been  paid                                            If the  prior  year’s tax     liability        was      reported     for a               
                                                                                               harbor.)
    on  the  original  premiums                                                                               less   than  12 months,          this  amount           must    be     annualized           
                                                                                               period

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for   purposes  of  both the          $20,000       ceiling       and  calculating          the                                                                            
                                                                                                                Completing Michigan Forms 
quarterly  payments  due  under  this  method.  Payments          at a more  
accelerated  pace  also will          qualify.               If the  year’s      tax     liability           is Treasury      captures  the information                 from     paper         CIT    returns                  
$800      or less,  estimates  are  not  required.                                                              using   an Intelligent         Character        Recognition          process.         If                       
                                                                                                                completing      a paper  return, avoid                 unnecessary              delays  caused                 
NOTE:  Reliance  on the               tax  liability    of  the      prior    year        as                 a  by   manual  processing by             following          the  guidelines           below                      
means      to avoid  interest  and  penalty  charges      is only  allowed      if                              so  the  return      is processed  quickly  and  accurately.  
you    had  business  activity               in Michigan      in that         prior  year and                
filed      a CIT  return  for that      prior   year.               A return  must  be filed                      • Use black or blue ink                 . Do  not  use  pencil,  red  ink,      or felt  tip  
to   establish    the  tax liability     for    that   prior      year,       even                if gross          pens.  Do  not  highlight  information.  
receipts      in the  prior  year  were  less  than  $350,000.      In addition,                                  • Print using capital letters  (UPPER  CASE).  Capital  letters  
    if your business       was not        in existence      in the  preceding year,                     no          are  easier      to recognize.  
safe  harbor  exists.      In such      a case,  estimates  must  be  based  on                                   • Print numbers like this:                     012345678    . Do                not  put      a slash  
the  CIT  liability  for  the  current  year.  There      is no  prior-year  safe                                   through  the  zero  (          )      or seven      (7).  
harbor  for      a taxpayer’s         first  CIT  tax  period. For                        a taxpayer’s  
first CIT     tax  period    the    estimates        must     equal          at least 85     percent              • Fill check boxes with an [X]                       . Do not    use   a   check      mark          [a    ].
of the   total  CIT     liability.                                                                                • Leave  lines/boxes  blank                          if they   do  not        apply  or            if the    
                                                                                                                    amount      is zero,  unless  otherwise  instructed.  
Amending Estimates Do not enter data in boxes filled with Xs                                 . 
If,   after  making payments,            the    estimated         tax               is substantially  
different    than  originally estimated,               recompute              the  tax and                        • Do  not  write  extra  numbers,  symbols,  or  notes   on  the                                             
adjust the    payment           in the next     quarter.                                                            return,   such  as cents,          dashes,      decimal        points         (excluding                   
                                                                                                                    percentages),   or  dollar signs             unless       otherwise           instructed.                  
Electronic Filing CIT Returns                                                                                       Enclose      any explanations            on               a separate sheet         unless                  
Michigan       has  an enforced         CIT     e-file   mandate.             Software                              instructed      to write explanations               on   the    return.         
developers      producing CIT            tax   preparation          software           and                        • Date  format   , unless            otherwise          specified,           should  be            in the  
computer-generated              forms  must  support e-file                   for  all    eligible                  following       format:  MM-DD-YYYY. Use                         dashes           (-)  rather              
Michigan forms            that  are   included   their   in        software         package.          All           than slashes        (/).   
eligible CIT     returns     prepared         using     tax      preparation             software      or         • Enter phone numbers using dashes (e.g.,  517-555-5555);  do  
computer-generated forms                 must   e-filed.   be                                                       not use    parentheses.         
Treasury     will  be enforcing          the    CIT    e-file     mandate.             The                        • Stay within the lines              when entering             information                in boxes.  
enforcement includes             not   processing        computer-generated                    paper              • Report losses and negative amounts                               with      a negative              sign  
returns that     are     eligible          toe-filed.beA   notice          will      bemailed to                    in front        of the number       (do   not    use   parentheses).             For  example,             
the taxpayer,      indicating       that   the   taxpayer’s           return      was        not   filed                 a loss  in  the  amount of          $22,459      should     be  reported           as                 
in   the     proper  form and      content      and    must       be  e-filed.         Payment                      -22,459.  
received  with   paper   a        return    will     be  processed             and       credited      to         • Percentages should be  carried out four  digits                                           to  the          
the taxpayer’s        account     even    when       the   return   not   is      processed.                        right      of the  decimal  point. Do              not  round      percentages.            For             
Treasury     will  continue to         accept       certain       Portable       Document                           example,      24.154266  percent becomes                       24.1542          percent.                   
Format (PDF)          attachments         with   CIT      e-filed        returns.   current   A                     When converting                  a percentage          to a decimal             number,          carry  
list       ofdefined attachments      is      available in      the CIT       “Michigan                             numbers out         six     digits       to the right         of the decimal        point.         For     
Tax    Preparer  Handbook for                       Electronic Filing            Programs,”                         example, 24.154266             percent        becomes        0.241542.            
which       is available on     the  Treasury           Web       site      atwww.MIfastfile.                   Report all amounts in whole dollars                         . Round down           amounts                    of 49
org  by  clicking  on “Tax            Preparer,”       then       “Corporate             Income                 cents      or less. Round       up  amounts            of 50 cents         or more.      If cents are        
Tax    Handbook”  for the          applicable          tax  year.     Follow           your                     entered      on the form,     they    will       be treated      as whole dollar       amounts.           
software     instructions for         submitting        attachments              with       an               
e-filed return.                                                                                                 Unitary Business Groups (UBGs) and Combined 
                                                                                                                Filing 
    If the   CIT   return includes         supporting           documentation               or              
attachments  that  are  not  on  the  predefined  list of      attachments,                                     Special UBG Instructions for Insurance Companies 
the return    can      still   e-filed.   be  Follow     your      software          instructions               By  definition,   UBG   a       (as     defined      below)       can    include        insurance              
for   including  additional attachments.                 The      tax  preparer             or                  companies,        standard taxpayers,            and      financial      institutions.                         
taxpayer   should  retain file           copies     of  all  documentation                  or                  However,      insome cases         not  all   members           of the      UBG       will  be                 
attachments.                                                                                                    included      on  the  same return.          All    standard        taxpayer          members                  
For more      information         and program           updates,       including  exclusions                    in       a UBG (except     those      owned       by    and      unitary          with   financial   a         
from  e-file,  visit  the  e-file  Web  site      at    www.MIfastfile.org  .                                   institution)     file      a single combined           return      on  the            CIT Annual 
                                                                                                                Return (Form  4891).  Financial institution                        members            of          a UBG        
The  taxpayer  may  be  required      e-fileto                    its  federal  return.  Visit                  (and     any  standard taxpayer            owned        by  and      unitary        with a                      
the   Internal  Revenue  Service (IRS)                  Web       site   at         www.irs.gov                 financial  institution   the   in       group)        file   combined   a            return     on      the    
for  more  information  on  federal  e-file  requirements  and  the  IRS                                        CIT Annual Return for Financial Institutions (Form 4908).                                             
Federal/State  Modernized  e-File  (MeF)  program. 

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Insurance      companies  are not                  specifically     excluded        from       the              
                                                                                                                Computing Penalty and Interest 
statutory definition                    of a UBG,      and    thus   may      be  members          of a
UBG.      However,          the  tax on      authorized           insurance      companies                      Annual   and       estimated returns            filed      late  or  without       sufficient         
   is equal      to 1.25    percent      of gross        direct  premiums written                   on          payment      of the  tax  due  are  subject          to a penalty          of 5 percent      of
property      or risk       located      or residing      in Michigan.                 There           is no    the  tax  due, for       the   first  two   months.        Penalty    increases         by  an        
traditional       apportionment for                insurance        companies.         Thus,                    additional      5 percent        per  month, or            fraction  thereof,      after     the       
even    when  an  authorized insurance                    company                   is unitary  with            second  month,          to a maximum          of 25 percent.  
another authorized            insurance          company,          this  will     have      no    effect        Compute   penalty  and interest                 for      underpaid    estimates         using         
in   calculating  the  tax. As                     a result,      a combined      return             is not     the   CIT Penalty and Interest Computation for Underpaid 
required  and  each  insurance company                        member                    of a UBG        will    Estimated Tax (Form 4899).                            If a taxpayer prefers     not        to file this   
file separately      on      Form    4905.                                                                      form,  Treasury  will  compute  the  penalty  and  interest  and  send  
For   further information              on    the  CIT,  see the      Michigan                                      a bill. 
Department              of     Treasury                (Treasury)             Web           site            at  The following          chart     shows    the    interest       rate  that      applies       to each  
www.michigan.gov/taxes                        . (Click    on “Corporate             Income                      filing period.             A new  interest      rate      is set          at 1 percent  above       the  
Tax”  on  the left       side           of the  page.)    Treasury  will  post updates                          adjusted prime            rate  for  each    six-month          period.       
here   and  via Revenue            Administrative             Bulletin        (available         on         
the “Reports         and     Legal    Resources”           link      on  the   left       side         of the      Beginning Date                               Rate                           Daily Rate 
page).                                                                                                             January 1, 2022                          4.25%                              0.0001164 
Exemption Guidelines                                                                                                  July 1, 2022                          4.27%                              0.0001170 
The   tax  imposed  and levied                under      the   Income         Tax   Act     does                   January 1, 2023                          5.65%                              0.0001548 
not  apply      to an insurance            company       authorized           under      Chapter            
46      or47 of   the    Insurance           Code   1956,   of       PA     218   1956,   of      MCL           For       a list   interest   of rates,  click     on     “Reports     and      Legal”      on     the    
500.4601   500.4673,   to          and      MCL        500.4701   500.4747.   to                                Treasury      Web  site  at           www.michigan.gov/treasury/                        . Interest  
                                                                                                                rates are     updated   Revenue   in         Administrative            Bulletins         (RABs).     
Filing the Correct Form 
   A different primary          return        and     instruction      booklet   available   is                 Signing the Return 
for   standard  taxpayers (Form                    4891)  and       financial    institutions                   All   returns  must  be signed              and   dated    by    the  taxpayer       or the           
(Form  4908).                                                                                                   taxpayer’s   authorized  agent.  This may                      be  the    owner,     partner,         
                                                                                                                corporate     officer,  or association             member.         The  corporate                         
Due Dates of Annual Returns                                                                                     officer  may  be  the  president,  vice  president,  treasurer,  assistant  
The tax        year   an   of insurance           company   the   is         calendar       year.     An        treasurer,    chief  accounting officer,                   or  any  other      corporate              
insurance      company  must  file the                 annual       return    on  or before                     officer  (such      taxas       officer)  authorized      signto               the  corporation’s  
March       1, 2023.        The   extension          that      is available      to the  standard               tax  return. 
taxpayer       under     MCL  206.685(4)      is not available                   to      insurance                 If someone            other  than  the above            prepared   the      return,  the               
companies.                                                                                                      preparer  must  give his            or      her business       address       and   telephone              
                                                                                                                number. 
Amending a Return 
                                                                                                                Print   the  name  of the         authorized          signer     and  preparer       in the               
To  amend      a current or      prior year          annual       return,     complete         the          
                                                                                                                appropriate  area  on  the  return. 
Amended Return for Corporate Income and Retaliatory Taxes                                                  
(Form        4906)  that is      applicable for          that     year,   explaining         the                Assemble  the  returns  and  attachments  (in  sequence  order)  and  
reason       for  the changes.         Include       all  schedules         or certificates                     use       a clip      in the  upper-left corner            or  rubber  band        the  pages         
filed   with  the original         return,         even  if not      amending          those                    together.   (Do          not  staple a      check to      the return.)        In an  e-filed          
schedules.        Enter  the  amounts on               the  amended           return       as  they             return,   the   preparation  software will                 assemble           the  forms   and        
should       be.  Do  not  include a      copy of      the original            return       with                PDF  attachments      thein            proper  order  automatically. 
your amended         return.       
                                                                                                                IMPORTANT REMINDER:                                 Failure to       include       all  the           
Current        forms are     available        on  Treasury’s         Web site            at                     required  forms  and  attachments  will  delay  processing  and  may  
www.michigan.gov/treasuryforms.                                                                                 result in      reduced or      denied  refund or      credit  forward or a          bill  for  
                                                                                                                tax  due. 
To  amend      areturn to      claim a   refund,           file    within      four      years   the   of   
original return’s         due  date.     Interest        will   paid   be     beginning   days   45             SIGNING AN E-FILED RETURN:                                      As  with any       tax  return        
after the      claim      isfiled or   the    due     date,   whichever   later.   is                           submitted      toTreasury on          paper,    an       electronic   tax      return   must              
                                                                                                                be   signed   by  an authorized             tax   return   signer,     the  Electronic                    
   If amending      returna    to      report a   deficiency,         penalty           and   interest      
                                                                                                                Return   Originator  (ERO), if              applicable,          and  the paid         tax            
may    apply  from the         due     date     of   the  original      return.        If any               
                                                                                                                preparer,       if applicable.  
changes are         made     federal     to a       income      tax   return      that      affect    the   
CIT    tax  base,  filing an         amended           return     is      required. To  avoid                   NOTE:    If        the   return   meets     one      of the  exceptions to      the e-file                
penalty, file      the   amended            return    within       120  days      after     the     final       mandate  and      beingis          filed  on  paper,      itmust be      manually  signed  
determination   the   by        IRS.                                                                            and  dated      theby      taxpayer      theor      taxpayer’s  authorized  agent. 

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The CIT   Fed/State        e-file  signature  process          is as follows: 
                                                                                                        Correspondence 
Fed/State  Returns:  Michigan will                   accept     the    federal       signature          An         address change    or  business    discontinuance     can be                  
method.     Michigan  does not           require       any  additional        signature                 reported     online  by  using Michigan         Treasury        Online  (MTO),          
documentation.                                                                                          Business     Tax     Services.  See         www.michigan.gov/mtobusiness  
State Stand Alone Returns:                    State  Stand Alone           returns      must            for      information. In     the  alternative,           Notice of Change or 
be   signed  using Form       MI-8879            (also    called    the Michigan                        Discontinuance  (Form  163), can             be   found   online    at          www. 
e-file   Authorization for      Business           Taxes   MI-8879,        Form                         michigan.gov/treasuryforms. 
4763).  Returns  are signed       by     entering         the  taxpayer    PIN                 in the  
                                                                                                                 Mail correspondence to: 
software    after  reading  the perjury             statement         displayed               in the  
                                                                                                                 Michigan  Department   Treasury   of       
software. The      taxpayer    PIN        will         be selected by    the   taxpayer,           or   
                                                                                                                 Business Taxes    Division,  CIT     Unit  
the taxpayer       may  authorize        his        or her tax  preparer            to select the   
taxpayer  PIN.                                                                                                   PO Box   30059  
                                                                                                                 Lansing MI   48909   
The   MI-8879  will  be printed            and     contain     the    taxpayer       PIN.           
The tax   preparer     will   retain      the     MI-8879            in his      or her records         To Request Forms 
as part        of the taxpayer’s  printed         return.   CIT        State  Stand       Alone     
e-filings   submitted  without                 a taxpayer  PIN will        be    rejected               Internet 
by Treasury.       Do  not  mail   the      MI-8879              to Treasury and         do  not        Current  and  past year      forms      are  available   on   Treasury’s      Web       
include the     MI-8879              as an attachment with        the    e-file   return.               site    at   www.michigan.gov/treasuryforms. 
                                                                                                        Alternate Format 
Mailing Addresses 
                                                                                                        Printed      material  in an     alternate   format      may  be  obtained    by        
Mail the  annual       return  and       all  necessary      schedules         to:                      calling (517)         636-6925.   
   With payment:                                                                                        TTY 
   Michigan  Department   Treasury   of                                                                 Assistance       is available using        TTY   through    the  Michigan        Relay   
   PO Box       30804                                                                                   Center   calling   by     1-800-649-3777   711.   or      
   Lansing MI          48909  
                                                                                                        Revenue Administrative Bulletins (RABs) 
   Without payment:                                                                                     Treasury provides          updates   via     RABs  on     the  Treasury    Web     site   
   Michigan  Department   Treasury   of                                                                       at www.michigan.gov/treasury/             . Currently     relevant    RABs      for  
   PO Box       30803                                                                                   the CIT       are:  
   Lansing MI          48909  
                                                                                                          •      2013-9, CIT   Definition   “Actively   of   Solicits”   
   Mail CIT quarterly estimate payments (Form 4913) to:                                                   •      2013-1,   CIT  Unitary Business     Group       Control    Test  and           
   Michigan  Department   Treasury   of                                                                          Relationship  Tests 
   PO Box       30774   
                                                                                                          •      2014-5, Michigan     CIT  Nexus      Standards    
   Lansing MI          48909-8274        
                                                                                                          •        Interest  Rates:  For a  list  of interest    rates, go  to                  
   Courier delivery service mail should be sent to:                                                              www.michigan.gov/treasury/             and  click on     “Reports    and       
   Michigan  Department   Treasury   of                                                                          Legal.” 
   7285 Parsons        Dr.  
   Dimondale MI         48821     
Make     all checks    payable    to “State         of Michigan.”          Print                    
taxpayer’s        FEIN,  the  tax year,       and   “CIT”      on     the  front     of      the    
check. Do     not  staple   the   check   the   to      return.      

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Michigan Department of Treasury 
4905 (Rev. 10-22), Page 1 of 2                                                                                                                                This form cannot be used as 
                                                                                                                                                              an amended return; use the 
                                                                                                                                                              Insurance Company Amended 
2022 Insurance Company Annual Return for                                                                                                                      Return for Corporate Income and 
                                                                                                                                                              Retaliatory Taxes (Form 4906).
Corporate Income and Retaliatory Taxes 
Issued under authority of Public Act 38 of 2011. 
1.  Taxpayer Name                                                                                                      2. Federal Employer Identification Number (FEIN) 

Address (Number, Street) 
                                                                                                                       3.        Check if Foreign Insurer 
City                                             State ZIP/Postal Code    Country Code  4. State of Incorporation (use 2 letter abbreviation) 

DIRECT PREMIUMS WRITTEN IN MICHIGAN                                                                                              A                                        B 
See instructions before completing lines 5 through 23.                                                                           Qualified Health Ins. Policies           All Other Policies 
5.  Gross direct premiums written in Michigan................................................................          5.                                     00                             00 
6.  Premiums on policies not taken.................................................................................    6.                                     00                             00 
7.  Returned premiums on canceled policies..................................................................           7.                                     00                             00 
8.  Receipts on sales of annuities ................................................................................... 8.                                     00                             00 
9.  Receipts on reinsurance assumed (see instructions) ................................................                9.                                     00                             00 
10.  Add lines 6 through 9.................................................................................................  10.                              00                             00 
11.  Direct Premiums Written in Michigan.  Subtract line 10 from line 5.  
     If less than zero, enter zero .......................................................................................  11.                               00                             00 
DISABILITY INSURANCE EXEMPTION 
12.  Disability insurance premiums written in Michigan, not including credit or disability  
     income insurance premiums (see instructions) ...........................................................  12.                                            00                             00 
13.  Proportional share of limit and phase-out. 
     Column A: Divide line 12, column A, by the sum of line 12, columns A and B. 
     Column B: Divide line 12, column B, by the sum of line 12, columns A and B.........                               13.                                    %                              % 
14.  Enter the sum of all disability insurance premiums from both columns of line 12  
     OR $190,000,000, whichever is less ...............................................................................................  14.                              00 
15.  Gross direct premiums from insurance carrier services everywhere...............................................  15.                                                 00 
16.  Phase out  ........................................................................................................................................  16. 280,000,000 00 
17.  Subtract line 16 from line 15. If less than zero, enter zero  ..............................................................  17.                                    00 
18.  Exemption reduction. Multiply line 17 by 2  ......................................................................................  18.                              00 
19.  Subtract line 18 from line 14. If less than zero, enter zero  ..............................................................  19.                                    00 
20.  Allocated reduced exemption. 
     Column A: Multiply line 19 by the percentage on line 13, column A. 
     Column B:Multiply line 19 by the percentage on line 13, column B .......................  20.                                                            00                             00 
21.  Adjusted tax base. 
     Column A: Subtract line 20, column A, from line 11, column A. 
     Column B: Subtract line 20, column B, from line 11, column B...............................        21.                                                   00                             00 
22.  Multiply line 21, column A, by 0.9391% and column B by 1.25% (0.0125)................  22.                                                               00                             00 
23.  Tax before credits. Add line 22, columns A and B............................................................................  23.                                    00 
CREDITS 
24.  Enter amounts paid from 1/1/2021 to 12/31/2021 to each of the following: 
     a.  Michigan Workers’ Compensation Placement Facility .....................................................................................  24a.                                       00 
     b.  Michigan Basic Property Insurance Association ..............................................................................................  24b.                                  00 
     c.  Michigan Automobile Insurance Placement Facility  ........................................................................................  24c.                                    00 
     d.  Property and Casualty Guaranty Association ..................................................................................................  24d.                                 00 
     e.  Michigan Life and Health Insurance Guaranty Association  .............................................................................  24e.                                        00 
25.  Add lines 24a through 24e......................................................................................................................................  25.                    00 
26.  Michigan Examination Fees or Regulatory Fee......................................................................................................  26.                                  00 
27.  Credit. Multiply line 26 by 50% (0.50) .....................................................................................................................  27.                       00 
28.  Subtract line 25 and line 27 from line 23  ................................................................................................................  28.                        00 
29.  Tax Liability after Historic Preservation Credit from Form 5793, line 11. If less than or equal to $100, enter zero  29.                                                                00 
30.  Total Recapture of Certain Business Tax Credits from Form 4902 .........................................................................  30.                                           00 
31.  Total Michigan Tax. Add line 29 and line 30 .........................................................................................................  31.                              00 

+  0000 2022 38 01 27 5                                                                                                                                         Continue and sign on Page 2 



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2022 Form 4905, Page 2 of 2                                                                                      Taxpayer FEIN 
Foreign and alien insurers complete lines 32 through 46. Use column A to report burdens that would be imposed by the taxpayer’s state of 
incorporation on a hypothetical Michigan company doing the same business in that state. Use column B to report actual burdens imposed by 
Michigan on the taxpayer. 
                                                                                                                 A                                                             B 
TAXES                                                                                                            State of Incorporation                                        Michigan 
32.  State of incorporation tax.......................................................................  32.                             X  X  X  X  X  X  X  X 
33.  Michigan Tax from line 31 ......................................................................  33.       X  X  X  X  X  X  X  X 
FEES AND ASSESSMENTS 
34.   Annual statement filing fee  ....................................................................  34.                            X  X  X  X  X  X  X  X
35.   Certificate of Authority renewal fee ........................................................  35.                                X  X  X  X  X  X  X  X 
36.   Certificate of Compliance  ......................................................................  36.                            X  X  X  X  X  X  X  X 
37.   Certificate of Deposit  .............................................................................  37.                        X  X  X  X  X  X  X  X 
38.   Certificate of Valuation ...........................................................................  38.                         X  X  X  X  X  X  X  X 

39.  Other fees. Include a detailed schedule of fees  ....................................  39. 
40.  Fire Marshall Tax  ...................................................................................  40.                        X  X  X  X  X  X  X  X 
41.  Second Injury Fund  ...............................................................................  41. 
42.  Silicosis and Dust Disease Fund ...........................................................  42. 
43.  Safety Education and Training Fund  .....................................................  43. 

44.  Other assessments. Include a detailed schedule of assessments ........  44. 
TOTAL 
45.  Total Taxes, Fees and Assessments.  Add lines 32 through 44 .............  45. 
46.  Retaliatory Amount. Subtract line 45, column B, from column A.  If less than zero, enter zero..............................  46.                                                   00 
47.   Total Tax Liability.  Add lines 31 and 46. Domestic insurers, enter amount from line 31.......................................  47.                                               00 

PAYMENTS AND TAX DUE 
48.  Overpayment credited from prior period return  ......................................................................................................  48.                         00 
49.  Estimated tax payments  .........................................................................................................................................  49.             00 
50.  Tax paid with request for extension  ........................................................................................................................  50.                 00 
51.  Michigan tax withheld  .............................................................................................................................................  51.          00 
52.   Workers’ Disability Supplemental Benefit (WDSB) Credit (attach document)  ........................................................  52.                                           00 
53.  Total Payments. Add lines 48 through 52  ...............................................................................................................  53.                      00 
54.   TAX DUE. Subtract line 53 from line 47. If less than zero, leave blank ..................................................................  54.                                    00 
55.  Underpaid estimate penalty and interest from Form 4899, line 38. ........................................................................  55.                                     00 
56.  Annual Return Penalty (see instructions)  ...............................................................................................................  56.                     00 
57.  Annual Return Interest (see instructions)  ...............................................................................................................  57.                    00 
58.   PAYMENT DUE. If line 54 is blank, go to line 59. Otherwise add lines 54 through 57 ...........................................  58.                                               00 

OVERPAYMENT, REFUND OR CREDIT FORWARD 
59.   Overpayment. Subtract line 47, 55, 56 and 57 from line 53. If less than zero, leave blank (see instructions) ...........  59.                                                     00 
60.   CREDIT FORWARD. Amount on line 59 to be credited forward and used as an estimate for next tax year.............                   60.                                             00 
61.   REFUND. Subtract line 60 from line 59 ..................................................................................................................  61.                     00 

Taxpayer Certification.  I declare under penalty of perjury that the information in     Preparer Certification.  I declare under penalty of perjury that this 
this return and attachments is true and complete to the best of my knowledge.           return is based on all information of which I have any knowledge. 
                                                                                        Preparer’s PTIN, FEIN or SSN 
      By checking this box, I authorize Treasury to discuss my return with my preparer. 
Authorized Signature for Tax Matters                                                    Preparer’s Business Name (print or type) 

Authorized Signer’s Name (print or type)             Date                               Preparer’s Business Address and Telephone Number (print or type) 

Title                                      Telephone Number 

+  0000 2022 38 02 27 3 



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                                                                          Instructions for Form 4905 
Insurance Company Annual Return for Corporate Income and Retaliatory Taxes 
Purpose                                                                                                        Line 2:  Enter  the  taxpayer’s Federal              Employer           Identification          
                                                                                                               Number  (FEIN).  Be sure               to use   the  same  account  number on                   
To   calculate  premiums tax                   levied  on  insurance           companies                       all forms.     The    taxpayer    FEIN      from      line       2 must be   repeated         in   
under  the  Corporate Income                     Tax  and           to claim      credits  against             the proper     location    on   page  2.   
that tax.    Foreign          insurers        must  also compare                burdens      in order  
to determine              if retaliatory tax           is due, and     calculate   that        tax,       if   NOTE:  Unless  already registered,               taxpayers         must   register                
due.                                                                                                           with   the  Michigan Department              of  Treasury        before   filing                 a   
                                                                                                               tax   return.  Taxpayers are     encouraged          to  register       online   at             
Effects of Public Act 222 of 2018                                                                              www.michigan.gov/businesstaxes                       . Taxpayers          that register           
PA 222           of 2018 amended         MCL       206.635,          which      levies           a tax on      with   Treasury  online receive           their  registration      confirmation                   
insurance  companies  equal      to 1.25%      of gross  direct  premiums                                      within seven    days.      
written  on  risk located                  or residing      in Michigan.          For      the  2022              If the  taxpayer    does     not  have  an FEIN,        the     taxpayer      must             
tax  year,  gross  direct  premiums  attributable      to qualified  health                                              an FEIN     before     filing   the CIT.     The    Web       site                      
                                                                                                               obtain
insurance   premiums  are taxed                  at  0.9391         percent.      (See     the                                                                      provides      information on                 
                                                                                                               www.michigan.gov/businesstaxes
instructions        under  “Direct Premiums                   Written         in  Michigan”                                      an FEIN. 
                                                                                                               obtaining
for      a definition  of qualified              health    insurance        policies.)     The              
remaining  portion      of the  tax  base      is still  taxed      at 1.25%.                                  Returns received without a registered account number will 
                                                                                                               not be processed until such time as a number is provided. 
Line-by-Line Instructions 
                                                                                                               Line   3:   Check    this  box         if the  company               is a foreign    insurer.  
Lines  not  listed  are  explained  on  the  form. 
                                                                                                               Alien  insurers  are  considered  foreign  insurers,  unless  their  port  
Do  not  enter  data in      boxes  filled  with  Xs.                                                          of  entry      is Michigan,      in which  case  the  company      is considered  
                                                                                                               domestic  for  the  filing      of this  return. 
Amended Returns:  To                    amend      a current          or  prior year       annual         
return,   complete           the Insurance Company Amended Return for                                          Line    4: Alien  insurers,  enter  the  two-letter  postal  code  for  the  
Corporate Income and Retaliatory Taxes                                 (Form  4906) that                  is   U.S.  state  that      is your  port      of entry. 
applicable for       that     year,  and         attach   a   separate    sheet    explaining         the   
reason for     the   changes.     Complete           and       file  all  schedules,        all   forms        Direct Premiums Written in Michigan 
and   all  attachments  filed  with the                original       return,     even              if not     NOTE:  For  line  5  through  line  13  and  line  20  through 
amending  information  on                     a particular  form      or schedule.  Include                    line  22,  complete  Column  A  to  report  Qualified  Health 
   a copy     of    an  amended  federal  return or                         a signed  and  dated               Insurance  Policies  and  Column  B  to  report  all  other 
Internal   Revenue            Service  (IRS)  audit document,                           if applicable.         policies. 
Do not include a copy of the original return with the amended                                                  “Qualified   health  insurance policies”             means         policies   written           
return. Find  detailed  instructions      on Form  4906.                                                       on   risk  located or     residing   in   this  state  that   are one     of   the              
Line 1:  Enter  the  complete name                     and    address         including       the              following  types      of policies:  
two-digit   abbreviation  for the                country      code.       See   the  list of                          (a)  Comprehensive  major  medical, regardless                             of whether  
country  codes      in the       Corporate Income Tax (CIT) Forms and                                                 the   policy      is eligible  for          a health  savings account           or         
Instructions for Insurance Companies  (Form  4904).                                                                   purchased  on  the  health  insurance  marketplace.  
NOTE:      Any      correspondence  regarding the                        return   filed    and/                       (b)  Student.  
or   refund  will  be sent                to the  address  provided on            this     form.                      (c)  Children’s  health  insurance  program.  
The taxpayer’s          primary       address            in Treasury files,        identified            as           (d)  Medicaid.  
the  legal  address and          used       for  all  purposes        other    than     refund                               Employer comprehensive,                regardless    of whether                     
                                                                                                                      (e)
and  correspondence  on                    a specific      CIT  return,  will not          change                           policy         is eligible  for       a health  savings account           or         
                                                                                                                      the
unless the     taxpayer           files    a   Notice of Change or Discontinuance                                     purchased on         the  health    insurance    marketplace.            
(Form 163)        with     Treasury     . 
                                                                                                                      (f) Multiple     employer        associations         or trusts and      any   other     
FOREIGN FILERS:                      Complete the              address      fields   follows:   as                    employer  associations  and  trusts. 
         Address: Enter the              postal    address       for    this    taxpayer.                      Qualified  Health  Insurance  Policies  are  taxed          at a special  rate,  
         City:   Enter  the  city name              for       this  taxpayer.     DO       NOT                 determined  annually  using      astatutory            formula. 
         include the       country        name   this   in     field.                                          Line 5: Enter  all  gross  direct  premiums  written  on  property      or
         State: Enter the         two-letter          state   province   or        abbreviation.               risk  located      or residing      in Michigan. 
              If there   no   is applicable       two-letter     abbreviation,              leave   this       Line 6:  Enter  premiums on            policies      not   taken   to  the  extent              
         field blank.                                                                                          these  premiums  were  included      in line    5.
         ZIP/Postal Code: Enter                   the   ZIP     Code   Postal   or          Code.              Line 7:  Enter  returned  premiums on                canceled      policies                to the  
         Country   Code:   Enter the                   two-letter         country   code                       extent  these  premiums  were  included      in line    5.
         provided in      this  tax  booklet. 
                                                                                                                                                                                                             8 



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Line 8: Enter receipts           on      sales      ofannuities to   the       extent    these          •   Michigan Basic            Property      Insurance       Association         
receipts were      included   line   in     5.                                                          •   Michigan Automobile               Insurance       Placement        Facility     
Line   9:   Enter  receipts  on reinsurance              premiums             assumed    to             •   Property and        Casualty      Guaranty        Association        
the extent    these    receipts   were         included      inline 5,   and         only   tax   if    •   Michigan Life          and    Health    Insurance         Guaranty     Association           
was paid    on    the  original   premiums.            
                                                                                                        •   Catastrophic  Claims  Association 
DISABILITY INSURANCE EXEMPTION                                                                          •   Assessment under           Health       Insurance         Claims    Assessment           Act   
Line 12: “Disability insurance”                   includes      any      policy   contract   or             (HICAA). 
of insurance      against       loss  resulting     from   sickness   from   or         bodily      
            death    by       accident,   both,   or    including         also  the   granting        Line   32:   Enter  the tax                   a Michigan company             would        pay        
injury or
of   specific  hospital benefits         and       medical,      surgical     and    sick-            to                                                                                                  
                                                                                                            the taxpayer’s state          of incorporation                   if it conducted         the  
care  benefits   any   to       person,    family   group,   or          subject   certain   to       same                                                                                                
                                                                                                              amounts and types              of    business     there     as the  taxpayer                
                                                                                                                                                                                                          
                                                                                                            is conducting       in   Michigan. Attach                a copy of the        state   of      
exclusions.
                                                                                                      incorporation’s           tax  form  on which          this    pro  forma    tax    on  the          
The      exclusion  for disability       insurance       premiums             does   not              hypothetical Michigan                company      was      calculated.      
include    credit insurance          or  disability      income        insurance                    
                                                                                                      Lines 34 through 44:                      In column    A,   “State      of Incorporation,”  
premiums.
                                                                                                      enter    the  amounts that          would       be paid     by                 a hypothetical        
Line 22, Column A: Multiply                      line     0.9391     21 by    percent.                Michigan          insurance company              doing    the   same   types       and                  
Line 22, Column B:              Multiply       line     1.25     21 by  percent       (0.0125).       amounts                                                                                             
                                                                                                                     of business in       the      taxpayer’s      home     state  that the               
                                                                                                      taxpayer      is doing      in Michigan. 
CREDITS                                                                                               Lines 39 and 41-44: In column                          B, “Michigan,” enter          the   actual       
Line   24:   Enter  the amounts              paid  to the  listed          facilities                 amounts paid                by the taxpayer        to Michigan. 
or   associations from         January       1, 2021,    to December           31,                  
2021,      including  special assessments.               Net   the    amounts        paid             Line 44:      Attach      a detailed schedule                of assessments. 
and      refunds  received during          2021    for   the     same      facility  or               Line 46:      Subtract       line   45,  column             B, from line  45,   column          A. If
association.       If refunds received            exceed  the     amount          paid   the   in     less than     zero,     enter   zero.   
year for    the   same      facility   association,   or  enter         zero.   
                                                                                                      PAYMENTS, REFUNDABLE CREDITS, AND TAX DUE 
Line 24c:     For   tax    years  beginning         on    and     after      January   2021,   1,     Line  49:  Enter  the total          tax     paid  with     the  quarterly       estimated           
amounts  paid   the   to       Michigan       Automobile          Insurance         Placement         tax returns.        
Facility   (MAIPF)  that  are attributable               to      the assigned        claims         
plan shall     not      beincluded in   the        calculation   this   of     credit.                Line 51:                                                                                            
                                                                                                                       Report here Michigan              Tax      withheld     for deferred               
                                                                                                      compensation           plans,  life insurance          and/or     lottery   annuities                
Line 26: Enter  the amount               of      Michigan Examination                Fees  or         issued          to a business       account      number        through    MCL       206.703(1).  
Regulatory Fees          paid   2022   in       (under    Michigan            Compiled      Law       Taxpayers  can  enter  the  Michigan  Tax  withheld  reported  on  the  
500.224).                                                                                             W-2G  and/or  1099R. 
Line  29:       If not    claiming       the   CIT  Historical Preservation              Tax          Also   report  any credit           for  the    taxpayer’s      allocated      share      of         
Credit, carry     the   amount        from     line     line     28 to 29.                            Michigan  flow-through  entity  (FTE)  tax  levied  on  and  paid  by  
Line  30:      Enter  the  Total Recapture             of      Certain Business        Tax            an                                                                                                  
                                                                                                            electing flow-through entity. Such an electing flow-through 
Credits from      Form         4902.   Include      acopy   Form   of         4902.                   entity                                                                                               
                                                                                                                should be indirectly            owned       by  this   taxpayer.       Include             a
                                                                                                      copy      of the  Schedule  K-1  with  the  Schedule  K-1  notes,      or other  
Retaliatory Instructions                                                                              supporting   documentation  received from                         the  electing      flow-  
For foreign and alien insurers only; domestic insurers skip                                           through  entity,      to support  the  credit  claimed  on  this  line. 
lines 32 through 46.                                                                                                   The Worker’s           Disability       Supplemental         Benefit                
                                                                                                      Line 52: 
Do   not   mail  this return     with      the   Michigan        Annual       Financial               (WDSB)   Credit      is available      to an             insurance  company subject                  
Statement.                                                                                            to   the  Worker’s  Disability Compensation                       Act  of  1969.      The            
                                                                                                      credit      is equal      to the    amount       paid  during  that tax          year   by  the      
Foreign    insurers  must pay            to  Michigan    the  same            type of                                   company  pursuant to           Section        352   of the       act, as           
                                                                                                      insurance
obligation       a similar     Michigan          insurer      is required      to pay      in the                    by  the  director      of the  Worker’s  Compensation  Agency,  
                                                                                                      certified
company’s        state      of domicile.  Enter all      items   that         are  required                                 of  Licensing and         Regulatory        Affairs    (LARA),                    
                                                                                                      Department
of       a Michigan    insurance       company.        Some      taxes       and   obligations                     the  tax  year. The       amount               of the  credit       is provided      to
                                                                                                      during
imposed   other   in    states   may      have      no  corresponding           requirement                             by  LARA.  For more            information          on  WDSB        credit         
                                                                                                      taxpayers
in  Michigan;  however,  this  does not                relieve   the       foreign   insurer                           contact  LARA,  Workers’  Compensation  Agency,  by  
                                                                                                      eligibility,
from the     obligation   computing   of            and   paying  the         correct   amount                       at 1-888-396-5041,            by  email      at wcinfo@michigan.gov  , 
                                                                                                      phone
of the    tax.                                                                                              visit  the  LARA  Web  site      atwww.michigan.gov/wca. 
                                                                                                      or
Do   not   include   the   following   Michigan   assessments,                                        Line 55:         If  penalty and       interest    are    owed      for not  filing                     
or   comparable assessments              in  the company’s             state of                       estimated  returns      or for  underestimating  tax,  complete  the                           CIT 
incorporation, in      the  retaliatory  calculation:                                                 Penalty and Interest Computation for Underpaid Estimated 
  • Michigan Worker’s            Compensation             Placement           Facility                Tax   (Form   4899),  to  compute penalty                      and  interest     due.                 If a

9 



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taxpayer chooses          not          to file  Form 4899,        Treasury will          compute           Other Supporting Forms and Schedules 
penalty     and  interest and            bill    for  payment.     (Form      4899  is                 
                                                                                                           The  following  forms  and  their  requested  attachments  should be      
available on      the  Web          at   www.michigan.gov/treasuryforms.) 
                                                                                                           included as      part of      this  return, as      applicable: 
Line 56: Refer      to the “Computing                   Penalty      and  Interest”        section     
                                                                                                             • Proof   of  payment  for any      items      listed  in  the  “Michigan”          
in Form      4904          to determine the        annual        return   penalty       rate     and   
                                                                                                               column  for  lines  40  through  43. 
use the    following      Overdue          Tax    Penalty     worksheets.         
                                                                                                             • Worker’s   Disability   Supplemental   Benefit   (WDSB)  
                                                                                                               Certificate. 
            WORKSHEET – OVERDUE TAX PENALTY 
A.   Tax due      from      Form       4905,      line       54 ........                          00 California  insurers              must  include Bureau      of  Fraudulent          
B.   Late      or insufficient                                                                                 Claims  assessments. 
     payment penalty              percentage       ................                               % New York domiciled                  companies  must  file and       pay  a            
C.   Multiply  line          A by line    B.....................                                  00           tentative retaliatory    tax   Michigan   to     by   the    Michigan     annual    
Carry  amount  from  line          C to Form  4905,  line  56.                                                 return   due  date  (March 1).    Form       4905    must     be  filed  after    
                                                                                                               the  actual  CT33 is      filed  with  New  York.  Transfer  the  CT33  
                                                                                                               numbers  onto  the  Form  4905  and  attach a      copy of      the  CT33  
Line 57: Use the          following        worksheet               to calculate Overdue          Tax               substantiate  the  taxpayer’s  claim. 
                                                                                                               to
Interest. 

          WORKSHEET – OVERDUE TAX INTEREST 
A.   Tax  due  from  Form  4905,  line      54 ........                                           00 
B.   Applicable  daily  interest  percentage     ..                                               % 
C.   Number      of days  return  was  past  due    ...
D.   Multiply  line          B by line       C .................... 
E.   Multiply  line          A by line       D ....................                               00 
Carry  amount  from  line          E to Form  4905,  line  57. 

NOTE:   If       the  late  period spans              more   than     one     interest    rate         
period,  divide  the  late period                into  the  number               of days      in each  
of   the  interest rate        periods    identified       under      the  “Computing                 
Penalty   and  Interest” section                 in  Form    4904     and  apply    the               
calculations      in the       Overdue  Tax  Interest  worksheet separately                           
to   each  portion of          the  late  period.      Combine           these  interest               
subtotals  and  carry  the  total      to Form  4905,  line  57. 
Line  59:            If the    amount      of    the  tax overpayment,              less  any          
penalty   and  interest  due on            lines      55,  56   and      57,           is less  than   
zero,  enter  the  difference  (as      apositive              number)  on  line  59. 
NOTE:   If       an  overpayment exists,                        a taxpayer  must elect                    a
refund      of all          or a portion      of the  amount  and/or  designate  all      or
   a portion      of the  overpayment      to be  used      as an  estimate  for  the  
next  CIT  tax  year.  Complete  lines  60  and          61 as applicable. 
Line 60:   If     the    taxpayer         anticipates           a CIT      or Retaliatory         Tax  
liability      in the  filing  period  subsequent      to this  return,  some      or
all      of any  overpayment             from  line  59  may be          credited   forward            
to  the  next  tax  year      as an  estimated  payment.  Enter  the  desired  
amount      to use          as an estimate  for  the  next  CIT  tax  year. 
Reminder:  Taxpayers must                        sign  and   date  returns.      Tax                   
preparers   must  provide                      a Preparer Taxpayer            Identification           
Number   (PTIN),  FEIN or                 Social      Security     number       (SSN),                    a
business  name,  and      abusiness                address  and  phone  number. 

                                                                                                                                                                                               10 



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                                                                   Country Codes 

Countries are  identified  by   two-letter codes       – Country Codes        – which  are required           on   some Michigan    Business  Tax  (MBT)  forms,  
including  the  annual  returns.  The  following          is a list      of countries  and  their  codes. 

AF   Afghanistan               CK   Cook Islands                   IN    India                            NR   Nauru                   SB   Solomon Islands 
AX   Åland Islands             CR   Costa Rica                     ID    Indonesia                        NP   Nepal                   SO   Somalia 
AL    Albania                  CI    Côte D’ivoire                 IR    Iran                             NL    Netherlands            ZA    South Africa 
DZ    Algeria                  HR   Croatia                        IQ    Iraq                             AN   Netherlands Antilles    GS   S. Georgia, Sandwich 
AS   American Samoa            CU   Cuba                           IE    Ireland                          NC   New Caledonia           KR   South Korea 
AD   Andorra                   CY   Cyprus                         IM   Isle Of Man                       NZ    New Zealand            ES    Spain 
AO   Angola                    CZ    Czech Republic                IL    Israel                           NI    Nicaragua              LK    Sri Lanka 
AI    Anguilla                 CD   Dem. Rep. of Congo             IT    Italy                            NE   Niger                   SD   Sudan 
AQ   Antarctica                DK   Denmark                        JM   Jamaica                           NG   Nigeria                 SR   Suriname 
AG   Antigua & Barbuda         DJ    Djibouti                      JP    Japan                            NU   Niue                    SJ    Svalbard, Jan Mayen 
AR   Argentina                 DM   Dominica                       JE    Jersey                           NF   Norfolk Island          SZ    Swaziland 
AM   Armenia                   DO   Dominican Republic             JO    Jordan                           KP   North Korea             SE   Sweden 
AW   Aruba                     EC   Ecuador                        KZ    Kazakhstan                       MP   N. Mariana Islands      CH  Switzerland 
AU   Australia                 EG   Egypt                          KE   Kenya                             NO   Norway                  SY    Syrian Arab Republic 
AT   Austria                   SV    El Salvador                   KI   Kiribati                          OM Oman                      TW  Taiwan 
AZ    Azerbaijan               GQ   Equatorial Guinea              KW   Kuwait                            PK    Pakistan               TJ    Tajikistan 
BS   Bahamas                   ER  Eritrea                         KG   Kyrgyzstan                        PW   Palau                   TZ    Tanzania 
BH  Bahrain                    EE   Estonia                        LA   Laos                              PS   Palestinian Occ. Terr.  TH   Thailand 
BD   Bangladesh                ET    Ethiopia                      LV   Latvia                            PA    Panama                 TL    Timor-Leste 
BB   Barbados                  FK    Falkland Islands              LB    Lebanon                          PG   Papua New Guinea        TG   Togo 
BY    Belarus                  FO   Faroe Islands                  LS    Lesotho                          PY    Paraguay               TK    Tokelau 
BE   Belgium                   FJ    Fiji                          LR    Liberia                          PE    Peru                   TO   Tonga 
BZ    Belize                   FI    Finland                       LY    Libya                            PH   Philippines             TT    Trinidad & Tobago 
BJ   Benin                     FR   France                         LI    Liechtenstein                    PN   Pitcairn                TN    Tunisia 
BM   Bermuda                   GF   French Guiana                  LT    Lithuania                        PL   Poland                  TR   Turkey 
BT    Bhutan                   PF    French Polynesia              LU    Luxembourg                       PT    Portugal               TM   Turkmenistan 
BO   Bolivia                   TF    Fr. Southern Terr.            MO   Macao                             PR   Puerto Rico             TC    Turks & Caicos 
BA  Bosnia, Herzegovina  GA         Gabon                          MK  Macedonia                          QA  Qatar                    TV   Tuvalu 
BW   Botswana                  GM   Gambia                         MG   Madagascar                        RE   Réunion                 UG   Uganda 
BV    Bouvet Island            GE  Georgia                         MW         Malawi                      RO  Romania                  UA  Ukraine 
BR   Brazil                    DE   Germany                        MY   Malaysia                          RU   Russian Federation      AE   United Arab Emir. 
IO   Brit. Ind. Ocean Terr.  GH     Ghana                          MV  Maldives                           RW  Rwanda                   GB  United Kingdom 
BN   Brunei Darussalam         GI    Gibraltar                     ML   Mali                              BL   St. Barthélemy          US   United States 
BG   Bulgaria                  GR   Greece                         MT   Malta                             SH   St. Helena              UM   U.S. Minor Out. Isl. 
BF    Burkina Faso             GL  Greenland                       MH  Marshall Islands                   KN   St. Kitts & Nevis       UY   Uruguay 
BI    Burundi                  GD   Grenada                        MQ   Martinique                        LC    St. Lucia              UZ    Uzbekistan 
KH  Cambodia                   GP  Guadeloupe                      MR  Mauritania                         MF  St. Martin               VU  Vanuatu    
CM  Cameroon                   GU  Guam                            MU  Mauritius                          PM  St. Pierre & Miquelon    VE   Venezuela    
CA  Canada                     GT  Guatemala                       YT   Mayotte                           VC   St. Vincent, Grenad.    VN  Vietnam    
CV   Cape Verde                GG  Guernsey                        MX  Mexico                             WS  Samoa                    VG    Virgin Islands, British 
KY  Cayman Islands             GN  Guinea                          FM  Micronesia                         SM  San Marino               VI    Virgin Islands, U.S. 
CF  Cent. African Repub.  GW Guinea-Bissau                         MD  Moldova                            ST   Sao Tome & Principe  WF      Wallis & Futuna 
TD   Chad                      GY   Guyana                         MC  Monaco                             SA    Saudi Arabia           EH   Western Sahara 
CL   Chile                     HT   Haiti                          MN   Mongolia                          SN   Senegal                 YE    Yemen 
CN   China                     HM  Heard, McDonald Isl.  ME   Montenegro                                  RS   Serbia                  ZM   Zambia 
CX   Christmas Island          VA    Holy See (Vatican)            MS   Montserrat                        SC   Seychelles              ZW   Zimbabwe 
CC   Cocos Islands             HN  Honduras                        MA   Morocco                           SL    Sierra Leone 
CO   Colombia                  HK   Hong Kong                      MZ   Mozambique                        SG   Singapore               XX Countries-Other 
KM   Comoros                   HU   Hungary                        MM   Myanmar                           SK   Slovakia 
CG   Congo                     IS    Iceland                       NA   Namibia                           SI    Slovenia 

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