Michigan Department of Treasury 
4909 (Rev. 03-22), Page 1 of 2 

2022 MICHIGAN Corporate Income Tax Amended Return for Financial Institutions 
Issued under authority of Public Act 36 of 2007.                                                                              (MM-DD-YYYY)                                  (MM-DD-YYYY)
1.  Return is for calendar year 2022 or for tax year beginning:                                                                                   and ending: 
2a.  Taxpayer Name or Designated Member (DM) if a UBG (print or type)                                                         Federal Employer Identification Number (FEIN) 

2b. Top-tiered parent entity filing the Federal Financial Institutions Examination Council (FFIEC) report                     Top-tiered parent entity FEIN 

2c. Street Address of Taxpayer or DM                                                                                          7. Organization Type 

City                                             State    ZIP/Postal Code      Country Code                                         Fiduciary               C Corp/         S Corp/  
                                                                                                                                                            LLC C Corp      LLC S Corp
3. Principal Business Activity                            4.  NAICS Code                                                      8a. Affiliated Group Election year (MM-DD-YYYY) (see instructions) 

5. Business Start Date in MI   6. If Final Return, Effective End Date Reason code for amending 
                                                                                                                                    Check if filing Michigan Unitary Business Group (UBG) 
                                                                                                                              8b.   return. (Include Form 4910.) 

   9. Apportionment Calculation:      a.  Michigan Gross Business     (if no Michigan Gross Business,                             enter zero)  .  9a.                                     00 
                                      b.  Total Gross Business...................................................................            9b.                                          00 
                                      c.  Apportionment Percentage.  Divide line 9a by line 9b.................                              9c.                                          % 

PART 1: FRANCHISE TAX 
                                                                                                                              A. As Originally Filed 
                                                                                                                              or Most Recently Amended           B. Correct Amount 

10.   Total Equity Capital. If less than zero, enter zero  ........................................  10.                                              00                                  00 

11.   Average daily book value of MI obligations. If less than zero, enter zero  ....                           11.                                   00                                  00 

12.   Average daily book value of U.S. obligations. If less than zero, enter zero  ...                          12.                                   00                                  00 

13.  Subtotal. Add lines 11 and 12 ......................................................................  13.                                        00                                  00 

14.   (Net Capital) Subtract line 13 from line 10...................................................  14.                                             00                                  00 

15.  Authorized insurance company  subsidiary: enter actual capital fund amount  15.                                                                  00                                  00 

16.  Minimum regulatory amount required ..........................................................  16.                                               00                                  00 

17.   Multiply line 16 by 125% (1.25)  ........................................................................ 17.                                   00                                  00 

18.  Enter the lesser of line 15 or line 17 ............................................................  18.                                         00                                  00 
19.   Tax Base (Net Capital for Current Taxable Year). Subtract line 18 from  
      line 14 ..........................................................................................................  19.                         00                                  00 

20.  Apportioned Tax Base. Multiply line 19 by percentage on line 9c  ...............  20.                                                            00                                  00 

21.  Multiply line 20 by 0.29% (0.0029)  ..............................................................  21.                                          00                                  00 
22.   Tax Liability after CIT Historic Preservation Credit from Form 5793,  
      line 11. If less than or equal to $100, enter zero ..........................................  22.                                              00                                  00 

23.   Total Recapture of Certain Business Tax Credits from Form 4902  ................                          23.                                   00                                  00 

24.   Total Tax Liability. Add lines 22 and 23   .....................................................  24.                                           00                                  00 

+  0000 2022 44 01 27 2                                                                                                                                     Continue and sign on Page 2. 

2022 Form 4909, Page 2 of 2                                                                                             Taxpayer FEIN 

                                                                                                                     A. As Originally Filed 
PART 2: PAYMENTS AND TAX DUE                                                                                         or Most Recently Amended                           B. Correct Amount 

25.  Overpayment credited from prior period return (MBT or CIT)  ......................  25.                                                00                                            00 

26.  Estimated tax payments  ...............................................................................  26.                           00                                            00 

27.  Tax paid with request for extension  ..............................................................  27.                               00                                            00 

28.  Michigan tax withheld  ...................................................................................  28.                        00                                            00 

29.   Amount paid with original return plus additional tax paid after original return was filed  ..................................  29.                                                  00 

30.  Total Payments. Add line 25, column B, through line 28, column B, and line 29 .............................................  30.                                                     00 

31.   Overpayment, if any, received on the original return and/or amended return(s)  .............................................  31.                                                   00 

32.  Total payments available. Subtract line 31 from line 30  ..................................................................................  32.                                     00 

33.   TAX DUE. Subtract line 32 from line 24, column B. If less than zero, leave blank ..........................................  33.                                                    00 

34.  Underpaid estimate penalty and interest from Form 4899, line 38 ..................................................................  34.                                              00 

35.  Annual Return Penalty (see instructions)  ........................................................................................................  35.                              00 

36.  Annual Return Interest (see instructions)  ........................................................................................................  36.                             00 

37.   PAYMENT DUE.  If line 33 is blank, go to line 38. Otherwise, add lines 33 through 36 ..................................  37.                                                        00 
PART 3: REFUND OR CREDIT FORWARD 
38.  Overpayment. Subtract line 24, column B, and lines 34, 35 and 36 from line 32. If less than zero, leave 
      blank (see instructions)....................................................................................................................................  38.                   00 

39.   CREDIT FORWARD. Amount on line 38 to be credited forward and used as an estimate for next tax year  .....  39.                                                                      00 

40.   REFUND. Subtract line 39 from line 38 ...........................................................................................................  40.                              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 

WITHOUT PAYMENT - Mail return to:              WITH PAYMENT - Pay amount on line 37                                                   Make check payable to “State of 
                                               and mail check and return to:                                                          Michigan.” Print taxpayer’s FEIN, the tax 
      Michigan Department of Treasury               Michigan Department of Treasury                                                   year, and “CIT” on the front of the check. 
      PO Box 30803                                  PO Box 30804                                                                      Do not staple the check to the return. 
      Lansing MI  48909                             Lansing MI  48909 

+  0000 2022 44 02 27 0 

                   Instructions for an amended Corporate Income Tax return 
                                             Forms 4892, 4906 and 4909 

Purpose                                                                          REASON CODE FOR AMENDING RETURN 
                                                                                 Include additional information on a separate sheet  
To calculate and file an amended Corporate Income Tax (CIT) 
return.                                                                          explaining the reason for amending the return. 
Standard  taxpayers  will  file  the CIT Amended Return   (Form            01    Amended a federal return. 
4892);  insurance  companies  will  file  theInsurance Company           02      Federal audit. 
Amended Return for Corporate Income and Retaliatory Taxes                03      Response to a Michigan Notice of Adjustment. 
(Form 4906); and financial institutions will file CIT Amended            04      Claiming a previously unclaimed credit or payment. 
Return for Financial Institutions (Form 4909). 
                                                                         05      Original return missing information/incomplete     
                                                                                 form. 
Amending a Return 
To amend a current or prior year annual return, use the amended          06      Correcting information/figures       originally  reported.  
return that is applicable for that tax year and taxpayer type.             07    Unitary Business Groups           : 
                                                                                 Adding or deleting member(s). 
Include  all  schedules  and  attachments  filed  with  the  original 
return, even if not amending them.   Do not  include a copy of           08      Due to litigation. 
the original return with the amended return.                             20      Other. 
Current and past year forms are available on Treasury’s Web              Amount paid with original return plus additional tax paid 
site atwww.michigan.gov/treasuryforms.                                   after original return was filed:   Enter all payments made with 
To amend a return to claim a refund, file within four years of           the  original  return  and  all  previous  returns  for  this  tax  year, 
the due date of the original return (including valid extensions).        as well as additional  payments made after those returns were 
Interest will be paid beginning 45 days after the claim is filed         filed.  
or the due date, whichever is later.                                     Overpayment, if any, received on the original return and/ 
If amending a return to report a deficiency, penalty and interest        or  amended return(s):  Enter the overpayment received (refund 
may apply from the due date of the original return.                      received plus credit forward created) on the original return and 
                                                                         all previous returns. 
If  any  changes  are  made  to  a  federal  income  tax  return  that 
affect CIT tax base, filing an amended return is  required. To           Standard Taxpayers Only 
avoid penalty, file the amended return within 120 days after the  
                                                                         “As Originally Filed or  Most Recently Amended” and 
final determination by the Internal Revenue Service. 
                                                                         “Correct   Amount”:   Where  the  amended  return  provides 
                                                                         a  Column  A  titled  “As  Originally  Filed  or  Most  Recently 
Line-by-Line Instructions 
                                                                         Amended,” provide the amount that was used on the taxpayer’s 
In most cases, the lines on the amended return match the lines           most  recent  return  that  the  new  return  will  amend.  Put  the 
on the originally filed return. Unless otherwise noted, use the          amended amounts in Column B, “Correct Amount.” 
instructions  for  the  original  return  to  complete  the  amended 
return.  Follow  the  instructions  for  the CIT Annual  Return          NOTE:   On  lines  9  through  11,  complete  only  with  amended 
(Form  4891)  to  complete  Form  4892;  follow  the  instructions       numbers. 
for  the Insurance Company Annual Return for Corporate             
                                                                         Insurance Companies and Financial Instituions 
Income and Retaliatory Taxes  (Form 4905) to complete Form 
4906; and follow the instructions for the CIT Annual Return for          Insurance  Companies  will  complete  all  lines  of  an  amended 
Financial Institutions (Form 4908) to complete Form 4909.                return  using  only  amended  numbers.  Financial  filers  will 
                                                                         complete an amended return with entries for both the original 
Federal  Employer  Identification  Number  (FEIN):         The      
                                                                         and   amended  figures   as  directed.  Taxpayers  must  file  using 
taxpayer FEIN from the top of page one must be repeated in                                                
                                                                         the appropriate amended return.
the space provided at the top of each succeeding page of the 
amended form. 
Reason code for amending return:       Using the following table, 
select  the  two-digit  code  that  best  represents  the  reason  for 
amending the return. Enter the code in the appropriate field in 
the taxpayer information at the top of page 1. Include additional  
explanation  on  a  separate  sheet  of  paper  and  attach  it  to  the 
amended return. 

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