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4 (Rev. 09-08)

Form 4, Instructions for Application for Extension of Time to File Michigan Tax Returns
                                                                                                     • Do not send a copy of the federal extension to the Michigan
General Information
                                                                                                     Department of Treasury. Retain a copy for your records.
An extension of time to file is not an extension of time to                                          • An extension of time to file is not an extension of time to pay. If
pay. Read the Line-by-Line Instructions before completing the                                        there will be any MBT liability, payment must be included with this
Application.                                                                                         form and/or appropriate estimated tax payments must have been
                                                                                                     made during the year, or the extension request will be denied.
Income Tax (Individual and Fiduciary)
                                                                                                     Late filing penalty and interest will accrue on the unpaid tax from
File Form 4 or a copy of your federal extension. An extension of
                                                                                                     the original due date of the return.
time to file the federal return automatically extends the due date
                                                                                                     • Penalty and interest for late filing is charged only if tax will be
of the Michigan return to the new federal due date. If you have
                                                                                                     due on the MBT annual return. If no tax will be due on the MBT
not been granted a federal extension, the Michigan Department of
                                                                                                     annual return, there is no need to request an extension to avoid
Treasury will grant a 180-day extension.
                                                                                                     penalty and interest.
• Do not file this form if a refund is expected or if you are not
submitting payment with this form.                                                                   Unitary Business Group (UBG)
• If at the time the extension is filed, it is determined additional                                 A UBG must file a combined return under the name and Federal
Michigan tax is due, send the amount due and a completed                                             Employer Identification Number (FEIN) or TR number of the
Michigan extension application or a copy of your federal extension                                   Designated Member of the standard taxpayer group. Only the
form. Extension requests received without payment on the account                                     Designated Member may submit a valid request for extension for
will not be honored and penalty and interest will accrue on the                                      the UBG. If any other member submits an extension request, it
unpaid tax from the original due date of the return.                                                 will not extend the time for filing for the combined return. Any
                                                                                                     payment attached to such request will be applied to the UBG.
• Do not attach a copy of the federal extension with Form 4.
                                                                                                     For more information on UBGs, see the General Information for
• Retain a copy of the extension form for your records.
                                                                                                     Standard or Financial Taxpayers.
• Payments made to date include withholding, estimated tax
payments, a credit forward from the previous tax year and any                                        Line-by-Line Instructions
other payments previously made for this tax year. Individual
                                                                                                     Lines not listed are explained on the form.
income tax filers should include any Michigan withholding
                                                                                                     Line 1: File a separate application for each tax type. Check the
Michigan Business Tax (MBT)
                                                                                                     box next to the appropriate tax. If filing a Composite Income
Michigan Business Tax filers must use this form to request an                                        Tax return (for nonresident partners or shareholders), check the
extension and must file it even if the Internal Revenue Service                                      “Fiduciary Tax” box.
(IRS) has approved a federal extension.
                                                                                                     Line 2: For MBT, enter the month and year your tax year ends.
• If this form is properly prepared meeting all listed conditions                                    For Individual Income and Fiduciary Taxes, enter the tax year for
and filed timely, Michigan Department of Treasury will grant the                                     which you are requesting the extension.
taxpayer an extension to the last day of the eighth month beyond
                                                                                                     Lines 3, 5 and 7: MBT and Fiduciary Tax filers, enter Federal
the original due date regardless of whether you are granted a
                                                                                                     Employer Identification Number (FEIN) or TR Number on line 3.
federal extension.


#                                         Detach here and mail with your payment. Do not fold or staple the application.
                                                                                                                                                          Issued under the authority of Public
 Michigan Department of Treasury, Form 4 (Rev. 09-08)
                                                                                                                                                          Acts 281 of 1967 and 36 of 2007.
 Application for Extension of Time to File Michigan Tax Returns
 Make check payable to “State of Michigan.” Print your Social Security or account number and “Michigan Extension” on the front of your check.
 Mail to: Michigan Department of Treasury, PO Box 30774, Lansing, MI 48909-8274
41. Extension request is for the following tax                              42. Month and Year Your Tax Year Ends (MM-YYYY)      4 3. Federal Employer Identification or TR Number
      Check oNly oNE
                                                                                                                                 4 5. Filer’s Social Security Number
             Income Tax*                      Fiduciary Tax*                          Check if extension is requested for good
                                                                              4.
                                              (includes Composite Filers)             cause - see instructions.
             Michigan Business Tax
                                                                                                                                 4 7. Spouse’s Social Security Number (If filing jointly)
                                                                                      Check if an extension was granted for
                                                                            46.       your federal tax return.
      * Do not file this form if a refund will be shown on the return.

        Business or Trust Name                                                                                                       9. Tentative Annual Tax
48.


410. Taxpayer’s Name (first name, middle initial, last name) or Fiduciary/Trustee Name                                             11. Total Payments Made to Date


                                                                                                                                 413. Payment Amount
412. Mailing Address
                                                                                                                                                                                      .00
Do Not Write iN this space
Form 4, Page 2

Income Tax filers only, enter Social Security number on line 5                                        extension, interest will be due on the unpaid or underpaid amount.
(and line 7 if filing jointly).                                                                       The interest rate is 1 percent above the adjusted prime rate and is
                                                                                                      adjusted on January 1 and July 1. Interest is charged from the due
Line 4: Filers who have not been granted a federal extension
                                                                                                      date of the return to the date the balance of the tax is paid.
may request an extension for good cause. Examples of good
cause include, but are not limited to: (a) taxpayer’s initial return,                                 Any one of the following penalties may also apply to the unpaid
(b) taxpayer’s final return, (c) a change in accounting period, and                                   tax:
(d) taxpayer’s books and records are not available or complete.                                       • The initial penalty is 5 percent of tax due. Penalty increases
Note: The inability to pay a tax due is not good cause.                                               by an additional 5 percent per month or fraction thereof, after the
Line 6: Check the box if you have been granted a federal                                              second month, to a maximum of 25 percent for failure to pay;
extension. Retain a copy of your federal extension for your files.                                    • 10 percent for negligence;
By checking the box on line 6, you are affirming that you have a
                                                                                                      • 25 percent for intentional disregard of the law.
federal extension in your possession. You must be able to produce
a copy for verification, if requested.
                                                                                                      When You Have Finished
Lines 8 and 10: These lines must both be completed to avoid
                                                                                                      Detach the Application for Extension form from the instructions
delays in processing.
                                                                                                      and mail to the address on the form. MBT filers who submit a
Penalty and Interest                                                                                  properly completed request will receive a written response at the
                                                                                                      legal address on file with the Michigan Department of Treasury.
The application and payment must be postmarked on or before the
                                                                                                      Income Tax and Fiduciary Tax filers will not receive a response.
original due date of the return. If the tax due is underestimated
and sufficient payment is not paid with the application for




                                                          Computation and Payment of Tax Due
  Estimate tax liability for the year and pay any unpaid portion of the estimate with the application for extension.

  A. Total annual tax liability. Enter here and carry to Application, line 9 .............................                                A.
  B. Payments made to date. Enter here and carry to Application, line 11 * ..........................                                     B.
  C. Credits (if any) .................................................................................................................   C.
  D. Add lines B and C ............................................................................................................       D.
  E. Estimated balance due. Subtract line D from line A ........................................................                          E.
  F. Amount paid with this Application. Enter here and carry to Application, line 13 ...........                                          F.
  * Payments made to date include withholding, estimated tax payments, a credit forward from the previous tax year and any other payments
    previously made for this tax year.

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4_144975_7 michigan.gov documents taxes

  • 1. Reset Form 4 (Rev. 09-08) Form 4, Instructions for Application for Extension of Time to File Michigan Tax Returns • Do not send a copy of the federal extension to the Michigan General Information Department of Treasury. Retain a copy for your records. An extension of time to file is not an extension of time to • An extension of time to file is not an extension of time to pay. If pay. Read the Line-by-Line Instructions before completing the there will be any MBT liability, payment must be included with this Application. form and/or appropriate estimated tax payments must have been made during the year, or the extension request will be denied. Income Tax (Individual and Fiduciary) Late filing penalty and interest will accrue on the unpaid tax from File Form 4 or a copy of your federal extension. An extension of the original due date of the return. time to file the federal return automatically extends the due date • Penalty and interest for late filing is charged only if tax will be of the Michigan return to the new federal due date. If you have due on the MBT annual return. If no tax will be due on the MBT not been granted a federal extension, the Michigan Department of annual return, there is no need to request an extension to avoid Treasury will grant a 180-day extension. penalty and interest. • Do not file this form if a refund is expected or if you are not submitting payment with this form. Unitary Business Group (UBG) • If at the time the extension is filed, it is determined additional A UBG must file a combined return under the name and Federal Michigan tax is due, send the amount due and a completed Employer Identification Number (FEIN) or TR number of the Michigan extension application or a copy of your federal extension Designated Member of the standard taxpayer group. Only the form. Extension requests received without payment on the account Designated Member may submit a valid request for extension for will not be honored and penalty and interest will accrue on the the UBG. If any other member submits an extension request, it unpaid tax from the original due date of the return. will not extend the time for filing for the combined return. Any payment attached to such request will be applied to the UBG. • Do not attach a copy of the federal extension with Form 4. For more information on UBGs, see the General Information for • Retain a copy of the extension form for your records. Standard or Financial Taxpayers. • Payments made to date include withholding, estimated tax payments, a credit forward from the previous tax year and any Line-by-Line Instructions other payments previously made for this tax year. Individual Lines not listed are explained on the form. income tax filers should include any Michigan withholding Line 1: File a separate application for each tax type. Check the Michigan Business Tax (MBT) box next to the appropriate tax. If filing a Composite Income Michigan Business Tax filers must use this form to request an Tax return (for nonresident partners or shareholders), check the extension and must file it even if the Internal Revenue Service “Fiduciary Tax” box. (IRS) has approved a federal extension. Line 2: For MBT, enter the month and year your tax year ends. • If this form is properly prepared meeting all listed conditions For Individual Income and Fiduciary Taxes, enter the tax year for and filed timely, Michigan Department of Treasury will grant the which you are requesting the extension. taxpayer an extension to the last day of the eighth month beyond Lines 3, 5 and 7: MBT and Fiduciary Tax filers, enter Federal the original due date regardless of whether you are granted a Employer Identification Number (FEIN) or TR Number on line 3. federal extension. # Detach here and mail with your payment. Do not fold or staple the application. Issued under the authority of Public Michigan Department of Treasury, Form 4 (Rev. 09-08) Acts 281 of 1967 and 36 of 2007. Application for Extension of Time to File Michigan Tax Returns Make check payable to “State of Michigan.” Print your Social Security or account number and “Michigan Extension” on the front of your check. Mail to: Michigan Department of Treasury, PO Box 30774, Lansing, MI 48909-8274 41. Extension request is for the following tax 42. Month and Year Your Tax Year Ends (MM-YYYY) 4 3. Federal Employer Identification or TR Number Check oNly oNE 4 5. Filer’s Social Security Number Income Tax* Fiduciary Tax* Check if extension is requested for good 4. (includes Composite Filers) cause - see instructions. Michigan Business Tax 4 7. Spouse’s Social Security Number (If filing jointly) Check if an extension was granted for 46. your federal tax return. * Do not file this form if a refund will be shown on the return. Business or Trust Name 9. Tentative Annual Tax 48. 410. Taxpayer’s Name (first name, middle initial, last name) or Fiduciary/Trustee Name 11. Total Payments Made to Date 413. Payment Amount 412. Mailing Address .00 Do Not Write iN this space
  • 2. Form 4, Page 2 Income Tax filers only, enter Social Security number on line 5 extension, interest will be due on the unpaid or underpaid amount. (and line 7 if filing jointly). The interest rate is 1 percent above the adjusted prime rate and is adjusted on January 1 and July 1. Interest is charged from the due Line 4: Filers who have not been granted a federal extension date of the return to the date the balance of the tax is paid. may request an extension for good cause. Examples of good cause include, but are not limited to: (a) taxpayer’s initial return, Any one of the following penalties may also apply to the unpaid (b) taxpayer’s final return, (c) a change in accounting period, and tax: (d) taxpayer’s books and records are not available or complete. • The initial penalty is 5 percent of tax due. Penalty increases Note: The inability to pay a tax due is not good cause. by an additional 5 percent per month or fraction thereof, after the Line 6: Check the box if you have been granted a federal second month, to a maximum of 25 percent for failure to pay; extension. Retain a copy of your federal extension for your files. • 10 percent for negligence; By checking the box on line 6, you are affirming that you have a • 25 percent for intentional disregard of the law. federal extension in your possession. You must be able to produce a copy for verification, if requested. When You Have Finished Lines 8 and 10: These lines must both be completed to avoid Detach the Application for Extension form from the instructions delays in processing. and mail to the address on the form. MBT filers who submit a Penalty and Interest properly completed request will receive a written response at the legal address on file with the Michigan Department of Treasury. The application and payment must be postmarked on or before the Income Tax and Fiduciary Tax filers will not receive a response. original due date of the return. If the tax due is underestimated and sufficient payment is not paid with the application for Computation and Payment of Tax Due Estimate tax liability for the year and pay any unpaid portion of the estimate with the application for extension. A. Total annual tax liability. Enter here and carry to Application, line 9 ............................. A. B. Payments made to date. Enter here and carry to Application, line 11 * .......................... B. C. Credits (if any) ................................................................................................................. C. D. Add lines B and C ............................................................................................................ D. E. Estimated balance due. Subtract line D from line A ........................................................ E. F. Amount paid with this Application. Enter here and carry to Application, line 13 ........... F. * Payments made to date include withholding, estimated tax payments, a credit forward from the previous tax year and any other payments previously made for this tax year.