Michigan Department of Treasury
4590 (Rev. 04-21), Page 1 of 2

2021 MICHIGAN Business Tax Annual Return                                                                                                                            Check if this is an
                                                                                                                                                                    amended return.
for Financial Institutions                                                                                                                                          See instructions.
Issued under authority of Public Act 36 of 2007.                                                   (MM-DD-YYYY)                                                     (MM-DD-YYYY)
1.  Return is for calendar year 2021 or for tax year beginning:                                                           and ending:
2.  Taxpayer Name (print or type)                                                                     )HGHUDO (PSOR\HU ,GHQWL¿FDWLRQ 1XPEHU  )(,1  RU 75 1XPEHU

Doing Business As (DBA)                                                                            8. Organization Type
                                                                                                                Fiduciary                                           S Corporation /
Street Address                                                                  Check if                                                                            LLC S Corporation
                                                                                new address.  
                                                                                (See instructions)              C Corporation / 
City                                             State          ZIP/Postal Code   Country Code                  LLC C Corporation

3. Principal Business Activity                                  4. Business Start Date in Michigan 8a.          Check if taxpayer (or any UBG member) has authority to 
                                                                                                                exercise trust powers only.

5.  NAICS (1RUWK $PHULFDQ ,QGXVWU\ &ODVVL¿FDWLRQ 6\VWHP  Code      ,I 'LVFRQWLQXHG  (ႇHFWLYH 'DWH  9.    Check if Filing Michigan Unitary Business Group Return.
                                                                                                         (Include Form 4752.)

10.  $SSRUWLRQPHQW &DOFXODWLRQa. Michigan Gross Business        (if no Michigan gross business,        enter zero) ..10a.                                                              00
                                            b. Total Gross Business ...................................................................10b.                                            00
                                            c. Apportionment Percentage.  Divide line 10a by line 10b .............10c.                                                                %

3$57    )5$1&+,6( 7$;                                         A                 B                      C                                    D                       E
Lines 11-14: If less than zero, enter zero.              2017                   2018               2019                                     2020                    2021
 11. Equity Capital ....................    11.
12.  Goodwill ............................. 12.
13.  Average daily book value 
     of Michigan obligations ......         13.
14.  Average daily book value 
     of U.S. obligations .............      14.
15.  Subtotal. Add lines 12 
     through 14 .........................   15.
16.  Net Capital. Subtract line 
     15 from line 11 ...................    16.
17.  a. Authorized insurance co. 
     subsidiary: Enter actual 
     capital fund amount ....... 17a.
     b. Minimum regulatory 
     amount required ............ 17b.
     c. Multiply line 17b by 
     125% (1.25) ................... 17c.
     d. Subtract line 17c from 
     17a.  If less than zero, 
     enter zero ...................... 17d.

18.  Add lines 16 and 17d .........         18.
19.  Add line 18, columns A through E. If less than zero, enter zero, skip lines 20-25, and enter zero on line 26 ........                                      19.                    00
20.  Net Capital for Current Taxable Year. Divide line 19 by number of tax years reported above ................................                                20.                    00
21.  Apportioned Tax Base. Multiply line 20 by percentage on line 10c ........................................................................                  21.                    00
22.  Multiply line 21 by 0.235% (0.00235) ..................................................................................................................... 22.                    00
23.  There is no amount to be entered on the line. Skip to line 26 ................................................................................             23. X X X X X X X X    00
24.  There is no amount to be entered on the line. Skip to line 26 ................................................................................             24. X X X X X X X X    00
25.  There is no amount to be entered on the line. Skip to line 26 ................................................................................             25. X X X X X X X X    00
26.  Total Liability Before All Credits. Enter amount from line 22 ...................................................................................          26.                    00
27.  Nonrefundable credits from Form 4568, line 40 .....................................................................................................        27.                    00
28.  Total Tax After Nonrefundable Credits. Subtract line 27 from line 26. If less than zero, enter zero ...................                                    28.                    00

+ 0000 2021 87 01 27 4                                                                                                                                          Continue and sign on Page 2.

2021 Form 4590, Page 2 of 2                                                                                     FEIN or TR Number

29.   Recapture of Certain Business Tax Credits from Form 4587, line 13 ...................................................................                              29.  00
30.   Total MBT Tax Liability.  Add lines 28 and 29 ....................................................................................................                 30.  00
31.   Corporate Income Tax adjustment from Form 4975, line 17 ................................................................................                           31.  00
32.   Total Tax Liability. Add lines 30 and 31 ..............................................................................................................            32.  00

3$57    3$<0(176  5()81'$%/( &5(',76 $1' 7$; '8(
33.   Overpayment credited from prior MBT return ..................................................             33.                  00
34.   Estimated tax payments .................................................................................. 34.                  00
35.   There is no amount to be entered on this line. Skip to line 36.........................                   35.  X X X X X X X X 00
36.   Tax paid with request for extension .................................................................     36.                  00
37.   Refundable credits from Form 4574, line 23 ...................................................            37.                  00
38.   Total Payments.  Add lines 33 through 37.  (If not amending, then skip to line 40) ...............................................                                 38.  00
      AMENDED a. Payment made with original and/or prior amended returns .. 39a.                                                     00
39.   RETURN  b. Overpayment from original and/or prior amended returns....                                     39b.                 00
      ONLY    c. Add lines 38 and 39a and subtract line 39b from the sum ... ....................................................                                        39c. 00
40.   7$; '8(  Subtract line 38 (or line 39c, if amending) from line 32.  If less than zero, leave blank .......................                                         40.  00
41.   Underpaid estimate penalty and interest from Form 4582, line 38 ........................................................................                           41.  00

42.   Annual return penalty (a)          %= (b)          00                   plus interest of (c)                   00 .  Total ..... 42d.                                   00
43.   PAYMENT DUE.  If line 40 is blank, go to line 44.  Otherwise, add lines 40, 41 and 42d .....................................                                       43.  00

3$57    5()81' 25 &5(',7 )25:$5'
44.   Overpayment. Subtract lines 32, 41 and 42d from line 38 (or line 39c, if amending). If less than zero, leave 
      blank (see instructions).......................................................................................................................................... 44.  00
45.   CREDIT FORWARD. Amount on line 44 to be credited forward and used as an estimate for next MBT tax year ....                                                        45.  00
46.   REFUND. Amount on line 44 to be refunded.........................................................................................................                  46.  00

7D[SD\HU &HUWL¿FDWLRQ   I declare under penalty of perjury that the information in     3UHSDUHU &HUWL¿FDWLRQ   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

           Return is due April 30 or on or before the last day of the 4th month after the close of the tax year.

WITHOUT PAYMENT - Mail return to:               WITH PAYMENT — Pay amount on line 43                                             Make check payable to “State of 
                                                and mail check and return to:                                                    Michigan.” Print taxpayer’s FEIN or 
      Michigan Department of Treasury           Michigan Department of Treasury                                                  TR Number, the tax year, and “MBT” on 
      PO Box 30783                              PO Box 30113                                                                     the front of the check. Do not staple the 
      Lansing MI  48909                         Lansing MI  48909                                                                check to the return.

+ 0000 2021 87 02 27 2

                                          Instructions for Form 4590 
      Michigan Business Tax (MBT) Annual Return for Financial Institutions
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