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Michigan Department of Treasury
4588 (Rev. 04-21), Page 1 of 2
2021 Insurance Company Annual Return for Check if this is an
amended return.
Michigan Business and Retaliatory Taxes See instructions.
Issued under authority of Public Act 36 of 2007.
1. Taxpayer Name )HGHUDO (PSOR\HU ,GHQWL¿FDWLRQ 1XPEHU )(,1 RU 75 1XPEHU
Address (Number, Street) Check if
new address. 3. Check if Foreign Insurer
(See instructions)
City State ZIP/Postal Code Country Code 4. State of Incorporation (use 2 letter abbreviation)
DIRECT PREMIUMS WRITTEN IN MICHIGAN
5. Gross direct premiums written in Michigan............................................................................................................. 5. 00
6. Premiums on policies not taken....................................................................... 6. 00
7. Returned premiums on canceled policies........................................................ 7. 00
8. Receipts on sales of annuities ......................................................................... 8. 00
9. Receipts on reinsurance assumed .................................................................. 9. 00
10. Add lines 6 through 9.............................................................................................................................................. 10. 00
11. Direct Premiums Written in Michigan. Subtract line 10 from line 5. If less than zero, enter zero ..................... 11. 00
DISABILITY INSURANCE EXEMPTION
12. Disability insurance premiums written in Michigan, not including credit or disability income insurance,
OR $190,000,000, whichever is less .................................................................................................................... 12. 00
13. Gross direct premiums from all lines of insurance carrier services
received everywhere .................................................................................... 13. 00
14. Phase out ...................................................................................................... 14. 280,000,000 00
15. Subtract line 14 from line 13. If less than zero, enter zero ........................... 15. 00
16. Exemption reduction. Multiply line 15 by 2 ............................................................................................................. 16. 00
17. Subtract line 16 from line 12. If less than zero, enter zero ..................................................................................... 17. 00
18. Adjusted Tax Base. Subtract line 17 from line 11 ................................................................................................... 18. 00
19. Michigan Business Tax Before Credits. Multiply line 18 by 1.25% (0.0125) ...................................................... 19. 00
CREDITS
20. Enter amounts paid from 1/1/2020 to 12/31/2020 to each of the following
a. Michigan Workers’ Compensation Placement Facility .............................. 20a. 00
b. Michigan Basic Property Insurance Association ....................................... 20b. 00
c. Michigan Automobile Insurance Placement Facility ................................. 20c. 00
d. Property and Casualty Guaranty Association ........................................... 20d. 00
e. Michigan Life and Health Insurance Guaranty Association ...................... 20e. 00
21. Add lines 20a through 20e...................................................................................................................................... 21. 00
22. a. Michigan Examination Fees ..................................................................... 22a. 00
b. Credit. Multiply line 22a by 50% (0.50) .............................................................................................................. 22b. 00
23. Tax Before Miscellaneous Nonrefundable Credits. Subtract lines 21 and 22b from line 19 ............................. 23. 00
24. Miscellaneous Nonrefundable Credits from Form 4596, line 28............................................................................. 24. 00
25. Michigan Business Tax After Nonrefundable Credits. Subtract line 24 from line 23. If less than zero, enter zero .. 25. 00
26. Recapture of Certain Business Tax Credits and Deductions from Form 4587, line 13 ........................................... 26. 00
27. Total Michigan Business Tax. Add lines 25 and 26 ............................................................................................ 27. 00
28. Corporate Income Tax Adjustment from Form 4974, line 20 .................................................................................. 28. 00
29. Tax Liability. Add lines 27 and 28 .......................................................................................................................... 29. 00
Return is due March 1, 2022.
WITHOUT PAYMENT: Mail return to: WITH PAYMENT: Pay amount on line 58 and mail check and return to:
Michigan Department of Treasury Michigan Department of Treasury Make check payable to “State of Michigan.” Print taxpayer’s
PO Box 30783 PO Box 30113 FEIN or TR Number, the tax year, and “MBT” on the front of
Lansing MI 48909 Lansing MI 48909 the check. Do not staple the check to the return.
+ 0000 2021 83 01 27 2 Continue and sign on Page 2
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