L-SS-4 City of Lansing Income Tax Division Employer’s Withholding Registration 
                                                                                                                                                               
Complete this registration form if required to withhold or voluntarily withholding and:  
 
1) Started a new business  2)Purchased an ongoing business   Started3)                                  doing business in the City of 
Lansing  4)Changed the type of business ownership (e.g. from sole proprietorship to partnership, 
incorporating a sole proprietorship or partnership)  
 
Employers that are required to register and withhold                                 :  
 
1) Employers having a location in the City of Lansing  2)Employers doing business in the City of Lansing, 
even though they are not located in the City. 
 
 Withhold Tax from Wages Paid to the Following Employees:  
 
1) All residents of the City of Lansing whether or not they work in the City  2)All non-residents who work in 
the City of Lansing. Withhold only on wages earned in the City of Lansing  
 
Online Withholding Site for Lansing: 
 
Do you process Lansing withholding tax?   Do you need to access the L941M, L941Q or LW3 
reconciliation form?  If so, please check the box below.  
                      
       Yes, please issue a pin number for online withholding. 
 
Mail to:             City of Lansing, Income Tax Division, 124 W Michigan Ave 1st FL, Lansing MI 48933  
Fax to:              City of Lansing, Income Tax Division. 517.483.6084 Attn: Withholding 
Email to:            Withholding@lansingmi.gov 
 
1.  TRADE NAME:                                                                                                   Employer’s Federal Identification Number 
                                                                                                                   
2.  OWNER’S NAME:  (IF DIFFERENT FROM TRADE NAME) 

3.  MAIN OFFICE MAILING ADDRESS: 

4.  LANSING ADDRESS: 

5.  (CHECK TYPE OF ORGANIZATION)                                                    6.  LOCAL TELEPHONE  #                                  7.  EMAIL ADDRESS 
                                                                                                                                             
       SOLE PROPERITOR            PARTNERSHIP          CORPORATION        OTHER 
7.  NO. EMPLOYEES                                                                                       8.  ACCOUNTING PERIOD 
                                                                                                                                            
                                                                                                                        CALENDAR YEAR     FISCAL YEAR ENDING                               
9.  IF THIS BUSINESS WAS PREVIOUSLY OWNED BY ANOTHER EMPLOYER PRINT NAME BELOW:                         10.  GIVE THE DATE THE BUSINESS WAS ACQUIRED BY CURRENT 
                                                                                                        EMPLOYER 
                                                                                                         
SIGNATURE                                                                     TITLE                     DATE 
 
For more information email Withholding@lansingmi.gov or call the Income Tax Division at 517.483.4117.  
You can also refer to the Income Tax Ordinance, Income Tax Withholding guide.