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Michigan Department of Treasury                                                                                                        Attachment 13
4910 (Rev. 03-22), Page 1 of 3

2022 MICHIGAN Corporate Income Tax Unitary Business Group  
Combined Filing Schedule for Financial Institutions
Issued under authority of Public Act 38 of 2011.
IMPORTANT:  Read the instructions before completing this form
Designated Member Name                                                                    Federal Employer Identification Number (FEIN)

PART 1: 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). If more than 
one page is needed, on each additional page repeat the DM’s name and FEIN in the field at the top of the page, but not on line 1.
Persons included in the Federal Financial Institutions Examination Council (FFIEC) report that are not members of the UBG are listed in Part 5.

1.                                              A                                                       B
                                Member Name                                                             FEIN

PART 2A: APPORTIONMENT DATA FOR COMBINED RETURN
If more than one page is needed to complete Part 1, duplicate answers on lines 2 and 3 on all copies of this page.
NOTE: Complete line 20 and line 21 for each UBG                   A                        B                                           C
member before completing line 2 and line 3 for the 
                                                                  Gross Business of UBG                     Gross Business of UBG 
group.                                                            Mem. Before Eliminations Eliminations     Mem. After Eliminations

 2. Michigan Gross Business. Carry 2C to Form 4908, line 9a ....

 3. Total Gross Business. Carry 3C to Form 4908, line 9b .........

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2022 Form 4910, Page 2 of 3                                                     Designated Member FEIN

PART 2B: MEMBER DATA FOR COMBINED RETURN — Complete a separate copy of Part 2B for each UBG member listed in Part 1.
4. Member Name                                                                                    Member FEIN

     Check if the equity of this UBG member is not included in the Federal Financial Institutions Examination Council (FFIEC) report. If checked, 
     complete line 5 through line 13 and line 20 through line 25, and do not complete line 14 through line 19. (See instructions.)

5. Member Address (Street)                                                                        10. Organization Type

City                                                         State ZIP/Postal Code                    Fiduciary                                                           S Corporation /  
                                                                                                                                                                          LLC S Corporation
                                                   Beginning                    Ending                C Corporation /                                                     Partnership /  
                                                                                                      LLC C Corporation                                                   LLC Partnership
 6. Federal tax period included in 
     return (MM-DD-YYYY) ..........................
                                                                                                  11. Check if nexus                                                  12. Check if  
 7. If part year member, enter                                                                        with Michigan.                                                      new member.
     membership dates (MM-DD-YYYY) .....
8. NAICS Code                                      9. If a Final Return, Enter Effective End Date 13. Check if member only 
                                                                                                      by Affiliated Group Election

FRANCHISE TAX BASE

14.  Average daily book value of MI obligations. If less than zero, enter zero ........................................................                           14.                    00

15.  Average daily book value of U.S. obligations. If less than zero, enter zero .......................................................                          15.                    00

16.  Authorized insurance company subsidiary: enter actual capital fund amount .................................................                                  16.                    00

17.  Minimum regulatory amount required ..............................................................................................................            17.                    00

18.  Multiply line 17 by 125% (1.25) .......................................................................................................................      18.                    00

19.  Enter the lesser of line 16 or line 18 ................................................................................................................      19.                    00

MEMBER GROSS BUSINESS

20.  Michigan Gross Business. Sum line 20 entries of all UBG members and carry total to Part 2A, line 2A ........                                                 20.                    00

21.  Total Gross Business. Sum line 21 entries of all UBG members and carry total to Part 2A, line 3A ...............                                             21.                    00

PAYMENTS.  See instructions

22.  Overpayment credited from prior period return (MBT or CIT) .........................................................................                         22.                    00

23.  Estimated tax payments ..................................................................................................................................    23.                    00

24.  Tax paid with request for extension .................................................................................................................        24.                    00

25.  Michigan tax withheld ...................................................................................................................................... 25.                    00

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2022 Form 4910, Page 3 of 3             Designated Member FEIN

PART 3: AFFILIATES EXCLUDED FROM THE COMBINED RETURN OF FINANCIAL INSTITUTIONS
List every entity, with or without nexus, that meets the ownership test but is excluded from this return for one of the reasons listed in the instructions for 
Line 26D. See instructions. If an entity listed here is part of a federal consolidated group, attach a copy of federal Form 851.

26. A                              B    C                     D                                                                 E        F
 Number From                                                  Reason    Check (X) if 
Federal Form 851                                              Code for  Nexus with 
 (if applicable)                 Name   FEIN                  Exclusion Michigan                                                         NAICS Code

PART 4: PERSONS INCLUDED IN THE PRIOR COMBINED RETURN, BUT EXCLUDED FROM CURRENT RETURN
List each member included in the immediately preceding combined return of this DM that is not included on the return supported by this form. An entity that 
satisfies the criteria of Part 3 and Part 4 should be listed in each part. See the instructions for Line 27C for a list of reason codes.
27.                         A           B                                                                                               C
                            Name        FEIN                  Reason This Entity Is Not on Current Return

PART 5:  PERSONS INCLUDED IN THE FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL 
    (FFIEC) REPORT THAT ARE NOT MEMBERS OF THE UBG
If a company is included in the top-tiered parent entity’s FFIEC report (that company’s equity is included as part of the total equity capital of the return 
supported by this form), yet that company does not meet either the control test or relationship test required to be a UBG member, list that company here. 
(See instructions.)
28.                              A                                      B
                            Person Name                                 FEIN

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                                             Instructions for Form 4910 
                        Corporate Income Tax (CIT) Unitary Business Group 
                        Combined Filing Schedule for Financial Institutions

Purpose                                                                     combined  return  on  Form  4908  with  Form  4910  filed  in 
                                                                            support.
The purpose of this form is to:
                                                                            Form  4910  is  used  to  gather  and  combine  data  from  each 
• Identify  all  members  of  a  Unitary  Business  Group  (UBG)            financial institution member of the UBG to support the group’s 
that are reporting on this return, as well as other entities related        Form  4908  and  related  forms.  This  form  must  be  completed 
in various ways to the UBG taxpayer.                                        before the group’s Form 4908 and related forms are completed. 
• Gather, on a separate basis, data for each UBG member in a 
                                                                            Financial institutions include any of the following:
financial institution combined return.
                                                                            ○ A  bank  holding  company,  a  national  bank,  a  state 
NOTE: This is not the primary return. It is designed to support             chartered bank, a state chartered savings bank, a federally 
the CIT Annual Return for Financial Institutions (Form 4908)                chartered  savings  association,  or  a  federally  chartered 
submitted  on  behalf  of  the  UBG  by  the  Designated  Member            farm credit system institution.
(DM).  Even  if  there  is  only  one  financial  institution  member 
in  a  UBG,  that  member  must  file  this  form  in  support  of  its     ○ Any   person,  other  than  a  person  subject  to  the 
Form  4908.  See  “Filing  Procedures  for  UBGs”  later  in  these         tax  imposed  under  Chapter  12  of  the  Income  Tax  Act 
instructions for guidance.                                                  (Insurance Tax), that is directly or indirectly owned by an 
                                                                            entity described above and is a member of the UBG.
General Information About UBGs in CIT                                       ○ A  UBG  of  entities  described  in  either  or  both  of  the 
Unitary Business Group     means  a  group  of  United  States              preceding two bullets.
persons  that  are  corporations,  insurance  companies,  or                NOTE: Because the definition of financial institution for CIT 
financial institutions, other than a foreign operating entity, that         purposes  includes  any  entity  (except  an  insurance  company) 
satisfies  the  control  test  and  relationship  test.  If  an  Affiliated that is owned by a bank or other entity (as described above) and 
Group  Election  is  made  (see  instructions  for  Form  4891),            is a member of a UBG with its owner, this may cause an entity 
the  UBG  also  includes  all  members  of  the  affiliated  group,         that is not commonly thought of as a financial institution to be 
as  defined  in  Internal  Revenue  Code  (IRC)  §  1504(1)  except         treated as one for return filing purposes.
that  the  group  includes  only  US  persons  (no  foreign  persons 
or  foreign  operating  entities)  that  are  corporations,  financial      To complete this form and prepare a combined return, the UBG 
institutions  or  insurance  companies  that  satisfy  the  control         must select a DM. For purposes of a combined return filed by 
test  and  have  made  the  election  to  file  as  a  UBG.  Once  the      financial  institution  members  of  a  UBG, Designated Member    
election is made, the Affiliated Group is treated as a UBG for              means  a  financial  institution  member  that  has  nexus  with 
all purposes.                                                               Michigan and that will file the combined CIT return on behalf 
                                                                            of all financial institution members of the UBG. If the financial 
United States person is defined in IRC § 7701(a)(30).                       institution  member  that  owns  or  controls  the  other  financial 
A foreign operating entity means a United States corporation                institution members has nexus with Michigan, that controlling 
that  would  otherwise  be  a  part  of  a  UBG  that  is  taxable  in      member must serve as DM.
Michigan; has substantial operations outside the United States,             If that controlling member does not have nexus with Michigan, 
the  District  of  Columbia,  any  territory  or  possession  of  the       it  may  appoint  any  financial  institution  member  of  the  UBG 
United States except for the commonwealth of Puerto Rico, or                with nexus to serve as DM. That DM must continue to serve 
a political subdivision of the foregoing; and at least 80 percent           as such every year, unless it ceases to be a UBG member or the 
of  its  income  is  active  foreign  business  income  as  defined  in     controlling member attains Michigan nexus.
IRC § 871(l )(1)(B)(ii).
                                                                            The  DM  may  be  an  entity  other  than  the  top-tiered  parent 
For  more  information  on  UBGs,  see  “UBGs  and  Combined 
                                                                            entity if the top-tiered parent entity does not have nexus with 
Filing”  in Corporate Income Tax for Financial Instituitions 
                                                                            Michigan.  In that case, the top-tier parent entity’s total equity 
Booklet  (Form  4907).  Additional  information  can  be  found 
                                                                            capital is still used to calculate the tax base.
under  the  “Corporate  Income  Tax”  page  at www.michigan.
gov/taxes.  Revenue  Administrative  Bulletin  (RAB)  2018-12,              If a UBG is comprised of both standard members (not owned 
Unitary Business Group Control Test And Relationship Tests,                 by  and  unitary  with  a  financial  institution  in  the  UBG)  and 
is available under the “Reports and Legal” page.                            financial institutions, the UBG will have two DMs (one for the 
                                                                            standard  members  completing  Form  4891  and  related  forms, 
Filing Procedures for UBGs                                                  and one for the financial institution members completing Form 
                                                                            4908 and related forms).
By  definition,  a  UBG  can  include  standard  taxpayers, 
insurance  companies,  and  financial  institutions.  In  some              If this UBG also includes standard and/or insurance company 
cases, however, not all members of the UBG will be included                 members, those members will not report tax data on this form, 
on  the  same  return.  Financial  institution  members  file  a            but will be listed as excluded affiliates in Part 3.

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Standard  members  will  combine  and  report  their  data  using   Line-by-Line Instructions
CIT  Unitary  Business  Group  Affiliates  Excluded  from  the 
                                                                    Lines not listed are explained on the form. 
Return  of  Standard  Taxpayers  (Form  4896), CIT Data  for 
Unitary Business Group Members  (Form  4897),  and CIT              Dates must be entered in MM-DD-YYYY format.
Annual Return (Form 4891).
                                                                    For  additional  guidance,  see  the  “Supplemental  Instructions 
NOTE: Insurance company members will file separately, using         for  Financial  Members  in  UBGs”  in  the  CIT Forms and 
Insurance Company Annual Return for Corporate Income and            Instructions for Financial Institutions (Form 4907).
Retaliatory Taxes (Form 4905). Because insurance companies 
                                                                    Part 1: Unitary Business Group Members
always file separately, rather than on a combined return, there 
is no CIT insurance form that serves a function similar to that     In  Part  1,  list  only  those  members  of  the  UBG  that  are 
of Forms 4897 and 4910.                                             included on the annual return that is supported by this form. 
                                                                    If  more  than  16  members,  include  additional  copies  of  this 
                                                                    page of Form 4910 as needed, repeating the DM’s name and 
Example A: UBG A is composed of the following:                      FEIN in the field at the top of each page. All excluded UBG 
• Four standard members                                             members will be identified in Part 3.
• Three financial institutions (all have nexus in Michigan)         The Designated Member FEIN from the top of page 1 must be 
• Two insurance companies.                                          repeated in the proper location on pages 2 and 3.
All  members  of  UBG  A  are  owned  by  and  unitary  with        Lines  1A and 1B:   Beginning  with  the  DM,  list  the  UBG 
one  of  the  standard  members  of  the  UBG.  UBG  A  will        financial institution members and their corresponding FEIN.
need  to  file  Form  4896,  Form  4897  and  Form  4891            NOTE:  A  taxpayer  that  is  a  UBG  must  file  a  combined 
containing the four standard members and Form 4910 and              return using the tax year of the DM. The combined return of 
Form  4908  containing  the  three  financial  institutions.  In    the  UBG  must  include  each  tax  year  of  each  member  whose 
Part 1 of each form, only the members that are included on          tax  year  ends  with  or  within  the  tax  year  of  the  DM.  For 
that form (either the four standard members, or the three 
                                                                    example, Taxpayer ABC is a UBG comprised of three financial 
financial institutions) will be listed. Form 4896 and Form 
                                                                    institutions: Member A, the DM with a calendar tax year, and 
4897 with standard members will be filed under the name 
                                                                    Members  B  and  C  with  fiscal  years  ending  March  31,  2019, 
and  Federal  Employer  Identification  Number  (FEIN)  of 
                                                                    and  September  30,  2019,  respectively.  Taxpayer  ABC’s  tax 
the group’s standard DM. One of the financial institutions 
                                                                    year  is  that  of  its  DM.  Thus,  Taxpayer  ABC’s  tax  year  ends 
will serve as DM for those three members and file Form 
                                                                    December 31, 2019, and its annual return is due April 30, 2020. 
4910  and  Form  4908.  On  Form  4896,  list  all  financial 
                                                                    That annual return must include the tax years of Members B 
and insurance members. On Part 3 of Form 4910, list all 
                                                                    and C ending March 31, 2019, and September 30, 2019.
standard  and  insurance  members.  The  two  insurance 
companies each will file a stand-alone Form 4905.                   If, in the previous example, Member A, the DM, instead had a 
                                                                    fiscal year ending July 31, 2023, the UBG’s tax year would end 
Example B: UBG B is composed of the following:                      July 31, 2023, and its annual return would be due November 30, 
                                                                    2023. The combined return for the UBG would include Member 
• Four  members  that  would  be  standard  (see  below) 
                                                                    A’s tax year of August 1, 2022 through July 31, 2023, Member 
unless owned by a financial institution
                                                                    B’s  tax  year  of  April  1,  2022  through  March  31,  2023  and 
• Three financial institutions (all have nexus in Michigan)         Member C’s tax year of October 1, 2021 through September 30, 
• Two insurance companies.                                          2022.
All  members  of  UBG  B  are  owned  by  and  unitary  with        Part 2A: Apportionment Data for Combined Return
one  of  the  financial  institutions  in  the  UBG.  Due  to  this When  completing  Part  1,  if  multiple  copies  of  this  page  are 
ownership by a financial institution, the four members that         required, provide the same answers to Part 2A, lines 2 and 3, 
otherwise  would  be  standard  are  defined  by  statute  to  be   on each copy of this page that is submitted. 
financial institutions. (See definition of financial institution 
earlier in these instructions.) Therefore, this UBG will not        Line  2:  Gross  business  is  defined  in  the  instructions  on 
                                                                    Form 4908, line 9a. On a combined return, gross business is 
file a Form 4896, Form 4897, or Form 4891. Seven members 
will file a combined return on Form 4908 and Form 4910,             calculated  after  eliminating  transactions  between  financial 
listing the two insurance members as excluded affiliates on         institution  members  of  the  UBG.  Enter  combined  gross 
Part  3  of  Form  4910.  The  two  insurance  companies  each      business  in  Michigan  of  all  financial  institution  members 
will file a stand-alone Form 4905.                                  on line 2A, show eliminations on line 2B, and show net after 
                                                                    eliminations  on  line  2C.  The  combined  gross  business  in 
                                                                    Michigan  equals  the  sum  of  line  17  of  Form  4910  of  every 
Role of the Designated Member: The DM speaks, acts, and             member of the group.
files the CIT return on behalf of the UBG for CIT purposes. 
Only the DM may file a valid extension request for the UBG.         Carry amount from line 2C to line 9a on Form 4908.
Treasury  maintains  the  UBG’s  CIT  tax  data  (e.g.,  prior  CIT NOTE:  For  a  UBG  that  includes  financial  institutions,  gross 
returns, overpayment credit forward) under the DM’s name and        business includes gross business in Michigan of every financial 
FEIN.

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institution included in that UBG without regard to whether the            business  in  Michigan.  To  complete  the  discontinuance  for 
financial  institution  has  nexus  in  Michigan.  Gross  business        Michigan  taxes,  file  Form  163,  which  is  available  at   www.
between  financial  institutions  included  in  a  UBG  must  be          michigan.gov/treasuryforms.
eliminated in calculating the gross business factor.
                                                                          Line  10: Identify the organization type of this member:
Line  3:  Enter  all  gross  business  everywhere  on  line  3A,  show    • Fiduciary  (a  decedent’s  estate,  and  a  Trust  taxed  federally 
eliminations on line 3B, and show net after eliminations on line 3C.      as  a  Trust  under  Subchapter  J  of  the  IRC.  A  grantor  Trust  or 
The gross business everywhere of the UBG equals the sum of line           “revocable living Trust” established by an Individual is not taxed 
18 of Form 4910 of every member of the group.                             as a separate entity, and is not within this Fiduciary category.);
Carry amount from line 3C to line 9b on Form 4908.                        • C Corporation (including an LLC, Trust, or other entity taxed 
                                                                          federally as a Corporation under Subchapter C of the IRC).
Part 2B: Member Data for Combined Return
                                                                          • S Corporation (including an LLC, Trust, or other entity taxed 
In  all  cases  with  one  or  more  financial  institutions  in  a  UBG, 
                                                                          federally as a Corporation under Subchapter S of the IRC).
complete  one  copy  of  Part  2B  for  each  financial  institution  in 
the UBG. Note that an entity that would otherwise be a standard           • Partnership (including an LP, LLP, LLC, Trust, or any other 
member but is owned by and unitary with a financial institution           entity taxed federally as a Partnership).
is defined by statute to be a financial institution. If a financial 
                                                                          NOTE:  An  entity  that  is  disregarded  for  federal  income  tax 
institution member (other than the DM) has two or more federal 
                                                                          purposes also will be disregarded for Michigan CIT purposes.  
tax periods ending with or within the filing period of this return, 
                                                                          Therefore,  as  with  the  federal  treatment,  the  activity  of  such 
use a separate copy of Part 2B for each of that member’s federal 
                                                                          an  entity  will  be  included  and  reported  on  the  return  (or  on 
periods.
                                                                          Form 4910) filed by the entity’s owner, as if that activity was 
NOTE: All UBG members must be reported in Part 2B. If the                 conducted directly by the owner.
equity of a UBG member is NOT INCLUDED in the FFIEC 
                                                                          Line  11: If this member has nexus with Michigan, check this 
report, check the box under line 4, then complete line 5 through 
                                                                          box. 
line  13,  and  line  17  through  line  21. DO  NOT  complete  line 
14 though line 16c, which is used to calculate the deductions             Line  12: This line does not apply to the first CIT return filed 
from total equity capital. These deductions may only be taken             by this UBG. For subsequent tax periods, check this box if this 
by UBG members that have equity included in the total equity              member was not included in the UBG’s preceding CIT return.
capital reported on the designated regulatory report.
                                                                          Line 13:  For  informational  and  statistical  purposes,  please 
Line  6:  List  the  member’s  tax  year,  for  federal  income  tax      check (with an X) this box if the following two conditions exist:  
purposes,  from  which  business  activity  is  being  reported  on 
                                                                            1)  The  group  to  which  this  member  belongs  is  a  UBG  by 
this copy of Part 2B.
                                                                               way  of  the  Affiliated  Group  Election  (line  8a  on  Form 
Line  7: If due to acquisition or disposition the control test and             4908 is filled), AND
relationship test were not both satisfied for this member’s entire 
federal tax year,  enter the beginning and ending dates of the              2)  The member for which this form is being filed does NOT 
period within this member’s federal tax year during which both                 meet  both  the  relationship  &  traditional  control  UBG 
tests were satisfied. If this member is part of a UBG based on                 tests.
the affiliated group election, and was not a member of the UBG            See  the  instructions  for CIT Annual Return for Financial 
for this member’s entire federal tax year, enter the beginning            Institutions  (Form  4908)  for  further  information  about  the 
and ending dates of the period within this member’s federal tax           election.  If  this  box  is  checked,  Form  4908,  line  8a, MUST  
year  during  which  the  control  test  was  satisfied.  These  dates    contain  a  date.  Once  an  election  is  made,  every  person  that 
constitute a short tax period for CIT purposes, even if there is          meets  the  definition  of  “affiliated  group,”  which  includes 
no corresponding short federal tax period. This member must               meeting the affiliated group ownership test, is a member of the 
prepare a pro forma federal return calculation for the portion of         UBG  by  way  of  the  Affiliated  Group  Election  (i.e.,  criterion 
its federal year during which it was a member of this UBG, and            #1 is met). The ownership test for an affiliated group may be 
use that pro forma calculation as the basis for reporting the tax         different  than  the  control  test  for  non-affiliated  group  UBGs. 
data required by Part 2B.                                                 Further,  the  determination  of  members  of  a  CIT  affiliated 
Line  8: Enter the taxpayer’s six-digit North American Industry           group is made without regard to whether the relationship test 
Classification System (NAICS) code. For a complete list of six-           is  met.  For  informational  and  statistical  purposes,  indicate 
digit  NAICS  codes,  see  the  U.S.  Census  Bureau  Web  site  at       whether  the  member  for  which  this  form  is  filed  would  meet 
www.census.gov/eos/www/naics/,  or  enter  the  same  NAICS               the traditional UBG tests had the group not made the Affiliated 
code used when filing Schedule K of U.S. Form 1120.                       Group Election.

Line  9:  Enter  the  date,  if  applicable,  on  which  this  member     Franchise Tax Base
went out of existence. Examples include dissolution of an entity 
                                                                          NOTE:  In  completing  the  combined  return,  a  member  of  a 
and  a  merger  in  which  this  member  was  not  the  surviving         unitary  business  group  of  financial  institutions  eliminates  its 
entity. Include any event in which the FEIN ceases to be used 
                                                                          investment  in  the  positive  Equity  Capital  of  other  members 
by  this  entity.  If  this  member  continues  to  exist,  DO  NOT 
                                                                          of  the  same  group.  Eliminations  occur  to  Equity  Capital  at 
use this column to report that this member has stopped doing 

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the  member  level.  Because  each  member  of  the  group  must       payments made by that member for any portion of its federal 
compute the Net Capital tax base in accordance with GAAP,              filing period that is included on this group return.
each member should represent a positive or zero Equity Capital 
                                                                       For example, if a non-DM member has a 12-month fiscal year 
before Eliminations.
                                                                       beginning April 1, 2013, and is a member of a calendar year 
Line  14: Under MCL 206.651(k), Michigan obligations means             UBG  throughout  that  period,  its  business  activity  from  April 
a bond, note, or other obligation issued by a governmental unit        1,  2013,  through  March  31,  2014,  will  be  reported  on  the 
described in Section 3 of the Shared Credit Rating Act, PA 227         group’s  December  31,  2014,  return.  If  that  member  pays  CIT 
of 1985, MCL 141.1053.                                                 quarterly estimates based on its federal tax year, it will make 
Sum the entries of all UBG members on line 14 and carry to             two estimates during 2013, before the DM’s (and group’s) filing 
Form 4908, line 11.                                                    period  begins.  Because  those  estimates  are  attributable  to 
                                                                       activity that will be reported on the group’s December 31, 2014, 
Line 15: United States obligations means  all  obligations  of 
                                                                       return, they should be included on the paying member’s copy of 
the United States exempt from taxation under 31 USC 3124(a) 
                                                                       Part 2B for the December 31, 2014, group return.
or exempt under the United States constitution or any federal 
statute,  including  the  obligations  of  any  instrumentality  or    Sum the entries of all UBG members on line 23 and carry to 
agency of the United States that are exempt from state or local        Form 4908, line 26.
taxation under the United States constitution or any statute of 
the United States.                                                     Line 24: Only the DM may request a filing extension for a UBG. 
                                                                       If  any  other  member  submits  an  extension  request,  it  will  not 
Sum the entries of all UBG members on line 15 and carry to             create a valid extension for the UBG, but any payment included 
Form 4908, line 12.                                                    with such a request can be credited to the UBG by entering that 
Line 16:  Enter  the  equity  capital  of  an  insurance  company      payment on this line in that member’s copy of Part 2B.
owned by the taxpayer, to the extent that the equity capital (this 
                                                                       Sum the entries of all UBG members on line 24 and carry to 
UBG member’s investment) is included in Form 4908, line 10.  
                                                                       Form 4908, line 27.
Consider only insurance companies as defined in MCL 206.607 
and subject to the Michigan’s CIT premiums tax, which does             Line  25:  Report  here  Michigan  Tax  withheld  for  deferred 
not  include  captive  insurance  companies.    For  purposes  of      compensation  plans,  life  insurance  and/or  lottery  annuities 
this deduction, equity capital is calculated in accordance with        issued to a business account number through MCL 206.703(1). 
Generally Accepted Accounting Principles.                              Taxpayers can enter the Michigan Tax withheld reported on the 
                                                                       W-2G and/or 1099R. 
Sum the entries of all UBG members on line 16 and carry to 
Form 4908, line 15.                                                    Also  report  any  credit  for  the  taxpayer’s  allocated  share  of 
Line 17: Enter the minimum capital fund amount required by             Michigan flow-through entity (FTE) tax levied on and paid by 
regulations for that insurance subsidiary.                             an electing flow-through entity. Such an electing flow-through 
                                                                       entity  should  be  indirectly  owned  by  this  taxpayer.  Include  a 
Sum the entries of all UBG members on line 17 and carry to 
                                                                       copy of the Schedule K-1 with the Schedule K-1 notes, or other 
the corresponding column on Form 4908, line 16.
                                                                       supporting  documentation  received  from  the  electing  flow-
Line 18: Sum the entries of all UBG members on line 18 and             through entity, to support the credit claimed on this line.
carry to Form 4908, line 17.
                                                                       Part 3: Affiliates Excluded From the Combined 
Line 20: Gross business is defined in the instructions on Form         Return of Financial Institutions
4908, line 9a.  Enter gross business in Michigan of the financial 
institution member reporting on Part 2B of this form. Combine          The statutory test for membership in a UBG is a group of U.S. 
line 23 for each financial institution member and enter on Part        persons (other than a foreign operating entity):
2A, line 2A.                                                           • One of which owns or controls, directly or indirectly, more 
Line 21:  Enter  gross  business  everywhere  of  the  financial       than  50  percent  of  the  ownership  interest  with  voting  rights 
institution member reporting on Part 2B of this form.  Combine         or ownership interests that confer comparable rights to voting 
line 18 for each financial institution member and enter on Part        rights of the other U.S. persons; and
2A, line 3A.                                                           • That has business activities or operations which result in a 
Line 22: Enter overpayment credited from prior return (MBT             flow of value between or among persons included in the UBG 
or CIT). When membership of a UBG changes from one filing              or  has  business  activities  or  operations  that  are  integrated 
period to the next, credit forward of an overpayment from the          with,  are  dependent  upon,  or  contribute  to  each  other.  Flow 
prior return remains with the DM’s account.                            of  value  is  determined  by  reviewing  the  totality  of  facts  and 
                                                                       circumstances of business activities and operations.
Sum the entries of all UBG members on line 22 and carry to 
Form 4908, line 25.                                                    A  person  that  would  be  a  standard  taxpayer  if  viewed 
                                                                       separately  is  defined  as  a  financial  institution  if  it  is  owned, 
Line 23:  All  CIT  estimated  payments  for  a  UBG  should           directly or indirectly, by a financial institution and is in a UBG 
be  made  by  the  DM.  Enter  estimates  paid  by  the  DM  on        with its owner.
this  line  of  the  DM’s  copy  of  Part  2B.  If  any  other  member 
                                                                       If eligible, a UBG may alternatively be determined by way of 
paid  estimates  attributable  to  this  group  return,  enter  those 
                                                                       an Affiliated Group Election (see instructions for Form 4891 
estimates  on  that  member’s  copy  of  Part  2B.  Include  all 

22



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for the CIT definition of an affiliated group, and for eligibility      Part 4: Persons Included in the Prior Combined 
and  other  details  about  the  election).    The  “greater  than      Return, but Excluded From Current Return
50%  test”  for  the  affiliated  group  may  be  different  than  the  The  purpose  of  Part  4  is  to  assist  Treasury  in  tracking 
traditional control test discussed above, and the affiliated group      membership changes of a UBG from year to year. If the reason 
is determined without regard to the relationship test discussed         the person is not on this return is because it did not satisfy the 
above.                                                                  flow of value, etc., test at any time during the filing period, list 
The  purpose  of  Part  3  is  to  identify  entities  for  which  the  the person on line 26, and do not enter it here.
ownership  test  described  above  is  satisfied  but  which  are  not  Line  27C: Reason  codes  for  a  person  being  included  in  last 
included  on  this  combined  return,  either  because  the  flow  of   year’s  return  but  not  on  the  combined  return  for  financial 
value/integration/dependence/contribution  test  is  not  satisfied     institutions supported by this form:
or because the member is excluded by statute. A new member 
whose net capital is not included in this return because its tax         10 The  person  no  longer  meets  the  control  test  but  the 
year  ends  after  the  filing  period  of  the  UBG  also  should  be      ownership interest is still greater than zero.
listed here.                                                             12 The  person  no  longer  meets  the  control  test  and  the 
NOTE: If there is only one financial institution member in a                ownership interest is zero.
UBG for a given tax year, that member must file this form in             14 Before the beginning of the filing period for this return, 
support of its Form 4908 and list all excluded members using                the person ceased to exist due to dissolution.
the reason codes below.
                                                                         16 Before the beginning of the filing period for this return, 
Line  26A:  If  a  person  being  listed  here  is  listed  on  federal     the  person  ceased  to  exist  due  to  a  merger  or  similar 
Form 851, enter the identifying number for that person from the             combination.
column called “Corp. No.” at the left edge of pages 1, 2, and 3          
of federal Form 851.                                                    If the reason is not listed among these reason codes, describe 
                                                                        the reason in 21 characters or less in the space provided.
Line  26D: From the following list of reason codes, select the 
number  for  the  reason  explaining  why  this  affiliate  is  being   Part 5: Persons included in the Federal Financial 
excluded  from  the  combined  return  of  financial  institutions      Institutions Examination Council (FFIEC) Report that 
supported by this form.                                                 are not Members of the UBG
                                                                        If a company is included in the top-tiered parent entity’s FFIEC 
1* Lacks business activities resulting in a flow of value or 
                                                                        report  (that  company’s  equity  is  included  as  part  of  the  total 
   integration  with,  dependence  upon,  or  contribution  to 
                                                                        equity  capital  of  the  return  supported  by  this  form),  yet  that 
   the group.
                                                                        company  does  not  meet  either  the  control  test  or  relationship 
2  Foreign operating entity.                                            test required to be a UBG member, list that company here.
3  Foreign entity.
4  Member has no CIT tax year (as a member of this UBG)                 Other Supporting Forms and Schedules
   ending with or within this filing period.                            For  each  member  that  files  a  separate  federal  return,  attach 
5  Insurance  company.  (Insurance  companies  always  file             copies of the same pages of that member’s federal return as are 
   separately.)                                                         required for a separate filer in similar circumstances. See the 
6  “Standard”  taxpayers  not  owned  by  a  financial                  “Attachments” section of Form 4908 instructions for guidance 
   institution.  (Financial  institutions  and  “standard”              on required pages of federal returns.
   taxpayers are not included on the same combined return.)             If  some  or  all  members  reporting  on  the  current  combined 
7  Other.                                                               return are also members of a federal consolidated group, each 
*NOTE:     Reason code number 1 does not apply to a group               member will prepare its portion of this Form 4910 on the basis 
that has made the Affiliated Group election.                            of  a  pro  forma  federal  return.  In  this  case,  attach  a  copy  of 
                                                                        the  applicable  pro  forma  form  and  schedules  as  listed  in  the 
If  you  have  questions,  call  the  Michigan  Department  of          “Attachments” section of Form 4908 instructions.
Treasury, Technical Services Section, at 517-636-4230.
                                                                        NOTE:  An  entity  that  is  disregarded  for  federal  income  tax 
Line  26E: If this person has nexus with Michigan, check this box.      purposes also will be disregarded for Michigan CIT purposes. 
Line  26F: Enter the entity’s six-digit North American Industry         Therefore,  as  with  the  federal  treatment,  the  activity  of  such 
Classification  System  (NAICS)  code.  For  a  complete  list  of      an  entity  will  be  included  and  reported  on  the  return  (or  on 
six-digit NAICS codes, see the U.S. Census Bureau Web site              Form 4910) filed by the entity’s owner, as if that activity was 
at www.census.gov/eos/www/naics/, or enter the same NAICS               conducted directly by the owner.
code used when filing the entity’s federal Form 1120, Schedule          Include completed Form 4910 as part of the tax return filing.
K, federal Form 1120S, or federal Form 1065.

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