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Michigan Department of Treasury                                                                                                                                         Attachment 10
4572 (Rev. 04-21)

2021 MICHIGAN Business Tax Charitable Contribution Credits
Issued under authority of Public Act 36 of 2007.

Taxpayer Name                                                                                 )HGHUDO (PSOR\HU ,GHQWL¿FDWLRQ 1XPEHU  )(,1  RU 75 1XPEHU

 1.  Tax liability prior to this credit from Form 4568, line 9 .................................................................................                    1.  00

COMMUNITY AND EDUCATION FOUNDATIONS CREDIT
If not claiming the Community or Education Foundations Credit, carry amount from line 1 to line 6.
                                                                                             Code 1   Code 2
 2.  Enter Community and/or Education Foundation Code(s) (see instructions) ........ 2.
 3.  Community and Education Foundations donation amount ..........................................................................3.                                   00
 4.  Multiply line 3 by 50% (0.50) .......................................................................................................................          4.  00
 5.  Community and Education Foundations Credit.  Enter the lesser of line 4, $5,000, or 5% (0.05) of 
     the tax on Form 4567, line 53.  Carry amount to Form 4568, line 10 ..........................................................                                  5.  00
 6.  Tax After Community and Education Foundations Credit.  Subtract line 5 from line 1. If less than zero, 
     enter zero ................................................................................................................................................... 6.  00

HOMELESS SHELTER/FOOD BANK CREDIT
,I QRW FODLPLQJ WKH +RPHOHVV 6KHOWHU )RRG %DQN &UHGLW  FDUU\ DPRXQW IURP OLQH   WR OLQH    
 7.  +RPHOHVV 6KHOWHU )RRG %DQN FDVK GRQDWLRQ DPRXQW .................................................................................                              7.  00
 8.  Multiply line 7 by 50% (0.50) .......................................................................................................................          8.  00
 9.  Homeless Shelter/Food Bank Credit.  Enter the lesser of line 8, $5,000, or 5% (0.05) of the tax on 
     Form 4567, line 53.  Carry amount to Form 4568, line 11 ...........................................................................                            9.  00
10.  7D[ $IWHU +RPHOHVV 6KHOWHU )RRG %DQN &UHGLW   6XEWUDFW OLQH   IURP OLQH    ,I OHVV WKDQ ]HUR  HQWHU ]HUR 
     (This line must be equal to Form 4568, line 12.) .........................................................................................                     10. 00

PUBLIC CONTRIBUTION CREDIT
If not claiming the Public Contribution Credit, complete line 11 and carry amount to line 15.
 11. Enter tax amount from Form 4568, line 16 ..................................................................................................                    11. 00
12.  Public Contribution donation amount...........................................................................................................                 12. 00
13.  Multiply line 12 by 50% (0.50) .....................................................................................................................           13. 00
14.  Public Contribution Credit. Enter the lesser of line 13, $5,000, or 5% (0.05) of line 11.
     Carry amount to Form 4568, line 17 ............................................................................................................                14. 00
15.  Tax After Public Contribution Credit.  Subtract line 14 from line 11. If less than zero, enter zero ................                                           15. 00

ARTS AND CULTURE CREDIT
If not claiming the Arts and Culture Credit, carry amount from line 15 to line 20.
16.  Arts and Culture donation amount (see instructions) ..................................................................................                         16. 00
17.  4XDOL¿HG GRQDWLRQ DPRXQW  6XEWUDFW         IURP OLQH     ,I OHVV WKDQ ]HUR  HQWHU ]HUR ............................                                            17. 00
18.  Multiply line 17 by 50% (0.50) .....................................................................................................................           18. 00
19.  Arts and Culture Credit. Enter the lesser of line 18, $100,000, or the tax from line 15.
     Carry amount to Form 4568, line 18 ............................................................................................................                19. 00
20.  Tax After Arts and Culture Credit.  Subtract line 19 from line 15. If less than zero, enter zero.
     (This line must be equal to Form 4568, line 19.) .........................................................................................                     20. 00

+ 0000 2021 31 01 27 1



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                                            Instructions for Form 4572 
                Michigan Business Tax (MBT) Charitable Contribution Credits
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Purpose 
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Special Instructions for Unitary Business Groups
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Credits
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                                                                        If aggregate contributions to Category A institutions 
DW www.michigan.gov/treasury XQGHU ³5HSRUWV  DQG  /HJDO                 exceed $50,000, enter that aggregate amount here
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HOMELESS SHELTER/FOOD BANK CREDIT
                                                                        TOTAL Arts and Culture donation amount .................
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)RU PRUH LQIRUPDWLRQ  VHH 0LFKLJDQ &RPSLOHG /DZ           
IRXQG RQOLQH DW www.legislature.mi.gov  
PUBLIC CONTRIBUTION CREDIT
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