Michigan Department of Treasury                                                                   Attachment 15
4580 (Rev. 04-21), Page 1 of 6

2021 MICHIGAN Business Tax Unitary Business Group  
Combined Filing Schedule for Standard Members
Issued under authority of Public Act 36 of 2007.
IMPORTANT:  Read the instructions before completing this form.
Designated Member Name                                                           )HGHUDO (PSOR\HU ,GHQWL¿FDWLRQ 1XPEHU  )(,1  RU 75 1XPEHU

PART 1A: UNITARY BUSINESS GROUP (UBG) MEMBERS
List the UBG members whose activity is included on the combined return supported by this form, beginning with the Designated Member 
(DM). Include all UBG members (with or without nexus), except those excluded in Part 3. If more than one page is needed, repeat the DM’s 
QDPH DQG )(,1 RU 75 1XPEHU LQ WKH ¿HOG DW WKH WRS RI WKH SDJH  EXW QRW RQ OLQH   
1.                                              A                                B
                                Member Name                                      FEIN or TR Number

+ 0000 2021 59 01 27 3                                                            Continue on Page 2.

2021 Form 4580, Page 2 of 6                                     Designated Member FEIN or TR Number

PART 1B:  MEMBER IDENTIFICATION
Complete a separate copy of Part 1B for each member listed in Part 1A.
2. Member Name                                                                                                    5. Organization Type

3. Member FEIN or TR Number                                                                                           Individual                                               C Corporation /  
                                                                                                                                                                               LLC C Corporation
4. Member Street Address                                                                                              Fiduciary                                                S Corporation /  
                                                                                                                                                                               LLC S Corporation
    City                                                State   ZIP/Postal Code                                       Partnership / LLC Partnership

                                                      Beginning                                             Ending
6. Federal Tax Period Included in Return                                                                          10. Check if Nexus with Michigan
 (MM-DD-YYYY) ........................................
7. If part-year member, enter                                                                                     11. Check if Registered for MBT
 membership dates (MM-DD-YYYY) .........
8. NAICS Code                                            ,I GLVFRQWLQXHG  HႇHFWLYH GDWH                           12. Check if New Member

    1DWXUH RI EXVLQHVV DFWLYLWLHV RU RSHUDWLRQV UHVXOWLQJ LQ D ÀRZ RI YDOXH EHWZHHQ PHPEHUV  RU LQWHJUDWLRQ  GHSHQGHQFH RU FRQWULEXWLRQ WR RWKHU PHPEHUV

PART 2A:  MEMBER DATA FOR COMBINED RETURN OF STANDARD TAXPAYERS
Enter data for the member listed in Part 1B.  Enter whole dollars only. 
 14. Michigan sales. (If no Michigan sales enter zero) .............................................................................................                       14.                  00
 15. Total sales.......................................................................................................................................................... 15.                  00
 16. Pro forma apportionment percentage. Divide line 14 by line 15 ............                             16.       %

0HPEHU 0RGL¿HG *URVV 5HFHLSWV
 17. Gross receipts ...................................................................................................................................................    17.                  00
 18. Inventory acquired during the tax year ..............................................................................................................                 18.                  00
 19. Depreciable assets acquired during the tax year ..............................................................................................                        19.                  00
 20. Materials and supplies not included in inventory or depreciable property .........................................................                                    20.                  00
 21. 6WDႈQJ FRPSDQ\  &RPSHQVDWLRQ RI SHUVRQQHO VXSSOLHG WR FXVWRPHUV .............................................................                                         21.                  00
,I WKH 8%* LV FODLPLQJ WKH 6PDOO %XVLQHVV $OWHUQDWLYH &UHGLW  VNLS WR OLQH    
 22. Deduction for contractors in SIC Codes 15, 16 and 17 (see instructions) .........................................................                                     22.                  00
     SIC Code:
 23. )LOP UHQWDO RU UR\DOW\ SD\PHQWV SDLG E\ D WKHDWHU RZQHU WR D ¿OP GLVWULEXWRU DQG RU ¿OP SURGXFHU ...................                                                  23.                  00
 24. 4XDOL¿HG $ႇRUGDEOH +RXVLQJ 3URMHFW  4$+3  GHGXFWLRQ
     a. Gross receipts attributable to residential rentals in Michigan ........... 24a.                               00
     b.  Number of residential rent restricted units in Michigan owned  
         E\ WKH 4$+3 ...................................................................................... 24b.
     c.  7RWDO QXPEHU RI UHVLGHQWLDO UHQWDO XQLWV LQ 0, RZQHG E\ WKH 4$+3 ....... 24c.
     d. Divide line 24b by line 24c and enter as a percentage ..................... 24d.                              %
     e. Multiply line 24a by line 24d  ............................................................ 24e.              00
     f.  /LPLWHG GLYLGHQGV RU RWKHU GLVWULEXWLRQV PDGH WR 4$+3 RZQHUV ......                                24f.      00
     g.  4$+3 'HGXFWLRQ  6XEWUDFW OLQH   I IURP OLQH   H ....................................................................................... 24g.                                           00
 25. Payments made by member licensed under Article 25 or Article 26 of the Occupational Code to 
     independent contractors licensed under Article 25 or Article 26 ........................................................................                              25.                  00
 26. Miscellaneous subtractions (see instructions) ...................................................................................................                     26.                  00
 27. 0RGL¿HG JURVV UHFHLSWV  6XEWUDFW OLQHV    WKURXJK    DQG   J WKURXJK    IURP OLQH    ..................................                                               27.                  00
 28. Enrichment prohibition for dealer of personal watercraft or new motor vehicles. Enter amount collected 
     during tax year. If zero, enter zero and skip line 29. If greater than zero, enter number here, then see 
     instructions for how to complete line 29 ............................................................................................................                 28.                  00
 29. Excess enrichment prohibition tax collected (see instructions) .........................................................................                              29.                  00

+ 0000 2021 59 02 27 1                                                                                                                                                         Continue on Page 3.

2021 Form 4580, Page 3 of 6                                      Designated Member FEIN or TR Number
                                                                                  Member FEIN or TR Number

PART 2A: MEMBER DATA FOR COMBINED RETURN OF STANDARD TAXPAYERS (Cont.) — Member Business Income
30. Business income. If negative, enter as negative. (If business activity protected under PL 86-272, complete 
    and attach Form 4581 or Form 4586, as applicable; see instructions.).............................................................                          30.                      00
31. Interest income and dividends derived from obligations or securities of states other than Michigan ................                                        31.                      00
32. Taxes on or measured by net income................................................................................................................         32.                      00
33. Tax imposed under MBT .................................................................................................................................... 33.                      00
34. Any carryback or carryover of a federal NOL ....................................................................................................           34.                      00
35. /RVVHV DWWULEXWDEOH WR RWKHU ÀRZ WKURXJK HQWLWLHV WD[HG XQGHU WKH 0%7 ..........................................................                           35.                      00
    Account No.
36. Royalty, interest, and other expenses paid to a related person not within the UBG (see instructions) ............                                          36.                      00
37. Miscellaneous additions (see instructions) .......................................................................................................         37.                      00
38. Dividends and royalties received from persons other than U.S. persons and foreign operating entities .........                                             38.                      00
39. ,QFRPH DWWULEXWDEOH WR RWKHU ÀRZ WKURXJK HQWLWLHV WD[HG XQGHU WKH 0%7 ..........................................................                           39.                      00
    Account No.
40. Interest income derived from U.S. obligations ..................................................................................................           40.                      00
41. Net earnings from self-employment. If less than zero, enter zero ....................................................................                      41.                      00
42. Miscellaneous subtractions (see instructions) ..................................................................................................           42.                      00
43. Business Income Tax Base. Add lines 30 through 37 and subtract lines 38 through 42 ..................................                                      43.                      00
44. Available MBT business loss carryforward from previous period MBT return (see instructions) .......................                                        44.                      00
45. 4XDOL¿HG $ႇRUGDEOH +RXVLQJ 'HGXFWLRQ  0HPEHUV FODLPLQJ WKH VHOOHU¶V GHGXFWLRQ RQO\  VNLS OLQHV   D WKURXJK   K DQG FDUU\ WKH DPRXQW IURP )RUP 
          OLQH    WR OLQH   L  0HPEHUV FODLPLQJ WKH 4$+3 GHGXFWLRQ RQO\  FRPSOHWH OLQHV   D WKURXJK   L  ,I FODLPLQJ ERWK GHGXFWLRQV  VHH LQVWUXFWLRQV 
    a. Gross rental receipts attributable to residential units in MI ............ 45a.                    00
    b. Rental expenses attributable to residential rental units in Michigan ...   45b.                    00
    c. Taxable income attributable to residential rental units.  
       Subtract line 45b from line 45a ........................................................ 45c.      00
    d. 1R  RI UHVLGHQWLDO UHQW UHVWULFWHG XQLWV LQ 0, RZQHG E\ WKH 4$+3 ....      45d.
    e. 7RWDO UHVLGHQWLDO UHQWDO XQLWV LQ 0LFKLJDQ RZQHG E\ WKH 4$+3 ........ 45e.
    f. Divide line 45d by line 45e and enter as a percentage....................  45f.                    %
    g. Multiply line 45c by line 45f.............................................................. 45g.   00
    h. /LPLWHG GLYLGHQGV  RWKHU GLVWULEXWLRQV PDGH WR SURMHFW RZQHUV ........ 45h.                        00
    i. 4XDOL¿HG $ႇRUGDEOH +RXVLQJ 'HGXFWLRQ  6XEWUDFW OLQH   K IURP OLQH   J ...................................................                               45i.                     00
46. There is no amount to be entered on this line ..................................................................................................           46.  x  x  x  x  x  x  x 00
47. There is no amount to be entered on this line ..................................................................................................           47.  x  x  x  x  x  x  x 00
48. 8QXVHG 0%7 %DVLF (QKDQFHG +LVWRULF 3UHVHUYDWLRQ &UHGLW FDUU\IRUZDUG ........................................................                               48.                      00
49. 8QXVHG 0%7 6SHFLDO &RQVLGHUDWLRQ +LVWRULF 3UHVHUYDWLRQ &UHGLW FDUU\IRUZDUG ...............................................                                 49.                      00
50. 8QXVHG 0%7 /RZ *UDGH +HPDWLWH &UHGLW FDUU\IRUZDUG ...................................................................................                      50.                      00
51. Unused MBT MEGA Federal Contract Credit carryforward ..............................................................................                        51.                      00
52. Unused MBT Individual or Family Development Account Credit carryforward .................................................                                  52.                      00
53. Unused MBT Bonus Depreciation Credit carryforward .....................................................................................                    53.                      00
54. 8QXVHG 0%7 %URZQ¿HOG 5HGHYHORSPHQW &UHGLW FDUU\IRUZDUG .........................................................................                           54.                      00
55. Unused MBT Film Job Training Credit carryforward .........................................................................................                 55.                      00
56. Unused MBT Film Infrastructure Credit carryforward .......................................................................................                 56.                      00
57. Unused MBT MEGA Plug-In Traction Battery Manufacturing Credit carryforward ...........................................                                     57.                      00
58. Unused MBT Anchor Company Payroll Credit carryforward ............................................................................                         58.                      00
59. Unused MBT Anchor Company Taxable Value Credit carryforward .................................................................                              59.                      00
60. Unused MBT MEGA Poly-Silicon Energy Cost Credit carryforward .................................................................                             60.                      00
61. Unused MBT MEGA Plug-In Traction Battery Integration Credit carryforward .................................................                                 61.                      00
62. Unused MBT MEGA Advanced Battery Engineering Credit carryforward ........................................................                                  62.                      00
63. Unused MBT MEGA Battery Manufacturing Facility Credit carryforward .........................................................                               63.                      00
64. Unused MBT MEGA Large Scale Battery Credit carryforward .........................................................................                          64.                      00
65. Unused MBT MEGA Advanced Lithium Ion Battery Credit carryforward ..........................................................                                65.                      00
66. Overpayment credited from prior MBT return ...................................................................................................             66.                      00
67. Estimated tax payments ................................................................................................................................... 67.                      00
68. There is no amount to be entered on this line ...................................................................................................          68.  x  x  x  x  x  x  x 00
69. Tax paid with request for extension ..................................................................................................................     69.                      00

+ 0000 2021 59 03 27 9                                                                                                                                              Continue on Page 4.

2021 Form 4580, Page 4 of 6                                                        Designated Member FEIN or TR Number

PART 2B: SUMMARY OF BUSINESS ACTIVITY FOR COMBINED RETURN OF STANDARD TAXPAYERS
NOTE: Not all lines from Part 2A are carried to Part 2B.                           ABCD
                                                                                   Combined Total                          Combined Total     Carry to  
                                                                                   Before Eliminations Eliminations        After Eliminations form, line
 14. Michigan sales ..........................................................                                                                4567, 11a
 15. Total sales ................................................................                                                             4567, 11b
 17. Gross receipts ..........................................................                                                                4567, 12
 18. Inventory acquired during the tax year ......................                                                                            4567, 13
 19. Depreciable assets acquired during the tax year ......                                                                                   4567, 14
 20. Materials and supplies not included in inventory or 
     depreciable property ..................................................                                                                  4567, 15
 21. 6WDႈQJ FRPSDQ\  &RPSHQVDWLRQ RI SHUVRQQHO 
     supplied to customers................................................                                                                    4567, 16
 22. Deduction for contractors in SIC Codes 15, 16  
     and 17 (see instructions) ...........................................                                                                    4567, 17
 23. Film rental or royalty payments paid by a theater 
     RZQHU WR D ¿OP GLVWULEXWRU DQG RU ¿OP SURGXFHU .........                                                                                 4567, 18
24g. 4$+3 'HGXFWLRQ ......................................................                                                                    4567, 19g
 25. Payments made by taxpayers licensed under 
     Article 25 or Article 26 of the Occupational Code to 
     independent contractors licensed under Article 25 or 
     Article 26...................................................................                                                            4567, 20
 26. Miscellaneous subtractions (see instructions) ..........                                                                                 4567, 21

 27. 0RGL¿HG JURVV UHFHLSWV                                                                            x  x  x  x  x  x  x                    N/A
     (line 17 minus lines 18 through 26) ..........................
 28. Enrichment prohibition for dealer of personal 
     watercraft or new motor vehicles.  Enter amount 
     collected during tax year...........................................                                                                     N/A
 29. Excess enrichment prohibition tax collected.............                                                                                 See instr.
 30. Business income ......................................................                                                                   4567, 28
 31. Interest income and dividends derived from obligations 
     or securities of states other than Michigan ..................                                    x  x  x  x  x  x  x                    4567, 29
 32. Taxes on or measured by net income.......................                                         x  x  x  x  x  x  x                    4567, 30
 33. Tax imposed under MBT ...........................................                                 x  x  x  x  x  x  x                    4567, 31
 34. Any carryback or carryover of a federal NOL ...........                                           x  x  x  x  x  x  x                    4567, 32
 35. /RVVHV DWWULEXWDEOH WR RWKHU ÀRZ WKURXJK HQWLWLHV WD[HG 
     under the MBT ..............................................................                                                             4567, 33
 36. Royalty, interest and other expenses paid to a 
     related person...........................................................                         x  x  x  x  x  x  x                    4567, 34
 37. Miscellaneous additions (see instructions) .................                                                                             4567, 35
 38. Dividends and royalties received from persons other 
     than U.S. persons and foreign operating entities .....                                            x  x  x  x  x  x  x                    4567, 38
 39. ,QFRPH DWWULEXWDEOH WR RWKHU ÀRZ WKURXJK HQWLWLHV WD[HG 
     under the MBT ..............................................................                                                             4567, 39
 40. Interest income derived from U.S. obligations ..........                                          x  x  x  x  x  x  x                    4567, 40
 41. Net earnings from self-employment. 
     If less than zero, enter zero ......................................                              x  x  x  x  x  x  x                    4567, 41
 42. Miscellaneous subtractions (see instructions) ..........                                                                                 4567, 42
 43. Business Income Tax Base ......................................                                   x  x  x  x  x  x  x                    N/A
 44. Available MBT business loss carryforward from 
     previous period MBT return(s)  .................................                                                                         4567, 46
45i. 4XDOL¿HG $ႇRUGDEOH +RXVLQJ 'HGXFWLRQ .....................                                                                               4567, 48i

+ 0000 2021 59 04 27 7                                                                                                     Continue on Page 5.

2021 Form 4580, Page 5 of 6                                                      Designated Member FEIN or TR Number

PART 2B: SUMMARY OF BUSINESS ACTIVITY FOR COMBINED RETURN OF STANDARD TAXPAYERS (CONT.)
                                                                                 ABCD
                                                                                 Combined Total                          Combined Total      Carry to  
                                                                                 Before Eliminations Eliminations        After Eliminations  form, line

 46. There is no amount to be entered on this line ..........                    x  x  x  x  x  x  x x  x  x  x  x  x  x x  x  x  x  x  x  x 4569, 2
 47. There is no amount to be entered on this line ..........                    x  x  x  x  x  x  x x  x  x  x  x  x  x x  x  x  x  x  x  x 4569, 6
 48. 8QXVHG 0%7 %DVLF (QKDQFHG +LVWRULF 3UHVHUYDWLRQ 
     Credit carryforward ....................................................                        x  x  x  x  x  x  x                     4584, 4
 49. 8QXVHG 0%7 6SHFLDO &RQVLGHUDWLRQ +LVWRULF 
     Preservation Credit carryforward ...............................                                x  x  x  x  x  x  x                     4584, 7
 50. 8QXVHG 0%7 /RZ *UDGH +HPDWLWH &UHGLW 
     carryforward...............................................................                     x  x  x  x  x  x  x                     4573, 20
 51. Unused MBT MEGA Federal Contract Credit 
     carryforward...............................................................                     x  x  x  x  x  x  x                     4584, 30
 52. Unused MBT Individual or Family Development 
     Account Credit carryforward ......................................                              x  x  x  x  x  x  x                     4573, 45
 53. Unused MBT Bonus Depreciation Credit 
     carryforward...............................................................                     x  x  x  x  x  x  x                     4573, 50
 54. 8QXVHG 0%7 %URZQ¿HOG 5HGHYHORSPHQW &UHGLW 
     carryforward...............................................................                     x  x  x  x  x  x  x                     4584, 40
 55. Unused MBT Film Job Training Credit carryforward ...                                            x  x  x  x  x  x  x                     4573, 64
 56. Unused MBT Film Infrastructure Credit carryforward ..                                           x  x  x  x  x  x  x                     4573, 70
 57. Unused MBT MEGA Plug-In Traction Battery 
     Manufacturing Credit carryforward .............................                                 x  x  x  x  x  x  x                     4584, 57
 58. Unused MBT Anchor Company Payroll Credit 
     carryforward...............................................................                     x  x  x  x  x  x  x                     4584, 65
 59. Unused MBT Anchor Company Taxable Value 
     Credit carryforward ....................................................                        x  x  x  x  x  x  x                     4584, 73
 60. Unused MBT MEGA Poly-Silicon Energy Cost 
     Credit carryforward ....................................................                        x  x  x  x  x  x  x                     4584, 81a
 61. Unused MBT MEGA Plug-In Traction Battery 
     Integration Credit carryforward ..................................                              x  x  x  x  x  x  x                     4584, 81b
 62. Unused MBT MEGA Advanced Battery Engineering 
     Credit carryforward ....................................................                        x  x  x  x  x  x  x                     4584, 81c
 63. Unused MBT MEGA Battery Manufacturing Facility 
     Credit carryforward ....................................................                        x  x  x  x  x  x  x                     4584, 81d
 64. Unused MBT MEGA Large Scale Battery Credit 
     carryforward...............................................................                     x  x  x  x  x  x  x                     4584, 81e
 65. Unused MBT MEGA Advanced Lithium Ion Battery 
     Credit carryforward ....................................................                        x  x  x  x  x  x  x                     4584, 81f
 66. Overpayment credited from prior MBT return ............                                         x  x  x  x  x  x  x                     4567, 60
 67. Estimated tax payments ............................................                             x  x  x  x  x  x  x                     4567, 61
 68. There is no amount to be entered on this line ...........                   x  x  x  x  x  x  x x  x  x  x  x  x  x x  x  x  x  x  x  x X X X
 69. Tax paid with request for extension ...........................                                 x  x  x  x  x  x  x                     4567, 63

Check all that apply to the Unitary Business Group.
 70. *URXS LGHQWL¿HG FRQVLVWV RI D JURXS RI 8 6  SHUVRQV  RQH RI ZKLFK RZQV RU FRQWUROV  GLUHFWO\ RU LQGLUHFWO\  PRUH WKDQ     RI WKH RZQHUVKLS 
     interests with voting or comparable rights of the others.
 71. Some or all members are included on a consolidated federal income tax return. If checked, attach a copy of federal Form 851.
 72. (DFK PHPEHU RI WKH JURXS KDV EXVLQHVV DFWLYLWLHV RU RSHUDWLRQV UHVXOWLQJ LQ D ÀRZ RI YDOXH EHWZHHQ WKH PHPEHUV RU KDV EXVLQHVV DFWLYLWLHV 
     or operations that are integrated with, dependent upon, or contribute to each other.
 73. $OO PHPEHUV RI WKH 8QLWDU\ %XVLQHVV *URXS DUH LQFOXGHG LQ WKLV XQLWDU\ ¿OLQJ 

+ 0000 2021 59 05 27 5                                                                                                   Continue on Page 6.

2021 Form 4580, Page 6 of 6                   Designated Member FEIN or TR Number

PART 3:  AFFILIATES EXCLUDED FROM THE COMBINED RETURN OF STANDARD TAXPAYERS
/LVW HYHU\ SHUVRQ  ZLWK RU ZLWKRXW QH[XV  IRU ZKLFK WKH ³JUHDWHU WKDQ    ´ RZQHUVKLS WHVW RI D 0LFKLJDQ 8QLWDU\ %XVLQHVV *URXS LV VDWLV¿HG  ZKLFK LV QRW 
included on the combined return of standard taxpayers that is supported by this form. Using the codes below, identify in column D why each person is not 
included in the combined return. If any persons listed here are part of a federal consolidated group, attach a copy of federal Form 851. 
REASON CODES FOR EXCLUSION:
     /DFNV EXVLQHVV DFWLYLWLHV UHVXOWLQJ LQ D ÀRZ RI YDOXH RU LQWHJUDWLRQ  6. Other.
    dependence or contribution to group.                                      ,QVXUDQFH FRPSDQ\   ,QVXUDQFH FRPSDQLHV JHQHUDOO\ ¿OH VHSDUDWHO\  
 2.  Foreign operating entity.                                             8. Financial institution. (Financial institutions and standard taxpayers 
 4. Foreign entity.                                                        generally are not included on the same combined return.)
 5.  Member has no MBT tax year (as a member of this UBG) ending 
    ZLWK RU ZLWKLQ WKLV ¿OLQJ SHULRG 

74. AB                                                                              CDEF
    Number From                                                                              Reason    Check (X) if 
    Federal Form 851                                                                         Code for  Nexus with 
    (if applicable)                      Name                              FEIN or TR Number Exclusion Michigan                          NAICS Code

PART 4: PERSONS INCLUDED IN THE PRIOR COMBINED RETURN, BUT EXCLUDED FROM CURRENT RETURN
List persons included as standard members in the immediately preceding combined return of this Designated Member that are not included as standard 
members on the return supported by this form. Persons that satisfy the criteria of Part 3 and Part 4 should be listed in each part. See column C instructions.
75.                            ABC
                                                                                             Reason This Person is Not on Current Return 
                               Name                                        FEIN or TR Number (See instructions for reason codes)

+ 0000 2021 59 06 27 3

                                         Instructions for Form 4580 
                    Michigan Business Tax (MBT) Unitary Business Group 
                     Combined Filing Schedule for Standard Members
Purpose                                                               •  0RUH WKDQ    SHUFHQW RI WKH WRWDO FRPELQHG YRWLQJ SRZHU RI 
                                                                         DOO RZQHUVKLS LQWHUHVWV ZLWK YRWLQJ  RU FRPSDUDEOH  ULJKWV  RU 
7KH SXUSRVH RI WKLV IRUP LV WR                                        •  0RUH  WKDQ      SHUFHQW  RI  WKH  WRWDO  YDOXH  RI  DOO  RZQHUVKLS 
• ,GHQWLI\ DOO PHPEHUV RI D 8QLWDU\ %XVLQHVV *URXS  8%*                  LQWHUHVWV ZLWK YRWLQJ  RU FRPSDUDEOH  ULJKWV.
• *DWKHU WD[ UHWXUQ GDWD IRU HDFK VWDQGDUG PHPEHU LQFOXGHG LQ         Relationship Tests. 7KH GH¿QLWLRQ RI D 8QLWDU\ %XVLQHVV *URXS 
  WKH FRPELQHG UHWXUQ RQ D VHSDUDWH EDVLV  PDNH DSSURSULDWH           UHTXLUHV  WKDW  WKH  JURXS  RI  SHUVRQV  KDYH  EXVLQHVV  DFWLYLWLHV  RU 
  HOLPLQDWLRQV  DQG GHWHUPLQH FRPELQHG 8%* GDWD IRU WKH WD[           RSHUDWLRQV WKDW HLWKHU 
  UHWXUQ 
                                                                         5HVXOW LQ D ÀRZ RI YDOXH EHWZHHQ RU DPRQJ SHUVRQV LQ WKH 
NOTE: 7KLV LV QRW WKH SULPDU\ UHWXUQ  ,W LV GHVLJQHG WR VXSSRUW       JURXS  RU
WKH MBT Annual Return  )RUP       VXEPLWWHG RQ  EHKDOI RI 
WKH 8%* E\ WKH 'HVLJQDWHG 0HPEHU  '0                                     $UH LQWHJUDWHG ZLWK  GHSHQGHQW XSRQ  RU FRQWULEXWH WR HDFK 
                                                                      RWKHU 
Refund Only:  ,I  FRPELQHG  DSSRUWLRQHG  RU  DOORFDWHG  JURVV 
UHFHLSWV  RI  DOO  PHPEHUV   EHIRUH  HOLPLQDWLRQV   LV  OHVV  WKDQ    $ WD[SD\HU QHHG RQO\ PHHW RQH RI WKH WZR DOWHUQDWLYH WHVWV WR 
         DQG WKHUH LV QR UHFDSWXUH  DQG WKH WD[SD\HU LV ¿OLQJ         VDWLVI\ WKH UHODWLRQVKLS WHVW 
)RUP        VROHO\  WR  FODLP  D  UHIXQG  RI  HVWLPDWHV  SDLG   )RUP     )ORZ  RI  YDOXH  LV  HVWDEOLVKHG  ZKHQ  PHPEHUV  RI  WKH 
      PXVW  DOVR  EH  LQFOXGHG   7KH  GHVLJQDWHG  PHPEHU  PXVW        JURXS  GHPRQVWUDWH  RQH  RU  PRUH  RI  IXQFWLRQDO  LQWHJUDWLRQ  
FRPSOHWH 3DUW  $  3DUW  %  VNLS OLQHV    WKURXJK      3DUW            FHQWUDOL]HG  PDQDJHPHQW   DQG  HFRQRPLHV  RI  VFDOH   ([DPSOHV 
DQG 3DUW   RI )RUP       )RU HDFK PHPEHU OLVWHG LQ 3DUW  $            RI  IXQFWLRQDO  LQWHJUDWLRQ  LQFOXGH  FRPPRQ  SURJUDPV  RU 
FRPSOHWH 3DUW  % DQG  $  VNLS OLQHV    WKURXJK      6HH )RUP          V\VWHPV  DQG  VKDUHG  LQIRUPDWLRQ  RU  SURSHUW\   ([DPSOHV  RI 
     IRU LQVWUXFWLRQV RQ FRPSOHWLQJ WKDW IRUP                         FHQWUDOL]HG  PDQDJHPHQW  LQFOXGH  FRPPRQ  PDQDJHPHQW  RU 
                                                                      GLUHFWRUV   VKDUHG  VWD൵  IXQFWLRQV   DQG  EXVLQHVV  GHFLVLRQV 
Tax Years Less Than 12 Months
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