Michigan AMENDED Insurance Company Annual Return for Corporate Income and Retaliatory Taxes

AMENDED Insurance Company Annual Return for Corporate Income and Retaliatory Taxes
Form 4906
Michigan Department of Treasury
4906 (Rev. 09-24), Page 1 of 2

2024 Insurance Company Amended Return
for Corporate Income and Retaliatory Taxes
Issued under authority of Public Act 38 of 2011.
1. Taxpayer Name

2. Federal Employer Identification Number (FEIN)

Address (Number, Street)
City

State

ZIP/Postal Code

Reason code for amending (see instr.)
Check if
3.
Foreign Insurer
Country Code 4. State of Incorporation (use 2 letter abbreviation)

A

DIRECT PREMIUMS WRITTEN IN MICHIGAN

B

See instructions before completing lines 5 through 23.
Qualified Health Ins. Policies
5. Gross direct premiums written in Michigan................................................................ 5.
00
6. Premiums on policies not taken................................................................................. 6.
00
7. Returned premiums on canceled policies.................................................................. 7.
00
8. Receipts on sales of annuities.................................................................................... 8.
00
9. Receipts on reinsurance assumed (see instructions)................................................. 9.
00
10. Add lines 6 through 9................................................................................................. 10.
00
11. Direct Premiums Written in Michigan. Subtract line 10 from line 5.
If less than zero, enter zero........................................................................................ 11.

All Other Policies

00
00
00
00
00
00

00

00

DISABILITY INSURANCE EXEMPTION
12.

Disability insurance premiums written in Michigan, not including credit or disability
income insurance premiums (see instructions)............................................................

12.

00

00

13.

Proportional share of limit and phase-out.
Column A: Divide line 12, column A, by the sum of line 12, columns A and B.
Column B: Divide line 12, column B, by the sum of line 12, columns A and B.......... 13.

%

%

14.
15.
16.
17.
18.
19.
20.

21.

22.
23.

Enter the sum of all disability insurance premiums from both columns of line 12
OR $190,000,000, whichever is less................................................................................................
Gross direct premiums from insurance carrier services everywhere...............................................
Phase out.........................................................................................................................................
Subtract line 16 from line 15. If less than zero, enter zero...............................................................
Exemption reduction. Multiply line 17 by 2.......................................................................................
Subtract line 18 from line 14. If less than zero, enter zero...............................................................
Allocated reduced exemption.
Column A: Multiply line 19 by the percentage on line 13, column A.
Column B: Multiply line 19 by the percentage on line 13, column B........................

14.
15.
16.
17.
18.
19.

00
00
280,000,000 00
00
00
00

20.

Adjusted tax base.
Column A: Subtract line 20, column A, from line 11, column A.
Column B: Subtract line 20, column B, from line 11, column B................................ 21.
Multiply line 21, column A, by 0.9477% and column B by 1.25% (0.0125)................ 22.
Tax before credits. Add line 22, columns A and B............................................................................

00

00

00
00

00
00

23.

00

CREDITS
24.

25.
26.
27.
28.
29.
30.
31.

+

Enter amounts paid from 1/1/2023 to 12/31/2023 to each of the following:
a. Michigan Workers’ Compensation Placement Facility......................................................................................
b. Michigan Basic Property Insurance Association...............................................................................................
c. Michigan Automobile Insurance Placement Facility.........................................................................................
d. Property and Casualty Guaranty Association...................................................................................................
e. Michigan Life and Health Insurance Guaranty Association..............................................................................
Add lines 24a through 24e......................................................................................................................................
Michigan Examination Fees or Regulatory Fee......................................................................................................
Credit. Multiply line 26 by 50% (0.50)......................................................................................................................
Tax liability before recapture. Subtract line 25 and line 27 from line 23..................................................................
Tax Liability after Historic Preservation Credit from Form 5793, line 11. If less than or equal to $100, enter zero.
Total Recapture of Certain Business Tax Credits from Form 4902..........................................................................
Total Michigan Tax. Add line 29 and line 30..........................................................................................................

0000 2024 40 01 27 6

24a.
24b.
24c.
24d.
24e.
25.
26.
27.
28.
29.
30.
31.

00
00
00
00
00
00
00
00
00
00
00
00
Continue and sign on Page 2

2024 Form 4906, Page 2 of 2

Taxpayer FEIN

Foreign and alien insurers complete lines 32 through 46. Use column A to report burdens that would be imposed by the taxpayer’s state of
incorporation on a hypothetical Michigan company doing the same business in that state. Use column B to report actual burdens imposed by
Michigan on the taxpayer.
A
B
State of Incorporation
Michigan
TAXES

X X X X X X X X

32.
33.

State of incorporation tax.......................................................................
Michigan Tax from line 31.......................................................................

32.
33.

34.
35.
36.
37.
38.

Annual statement filing fee.....................................................................
Certificate of Authority renewal fee.........................................................
Certificate of Compliance.......................................................................
Certificate of Deposit..............................................................................
Certificate of Valuation............................................................................

34.
35.
36.
37.
38.

39.
40.
41.
42.
43.

Other fees. Include a detailed schedule of fees.....................................
Fire Marshall Tax....................................................................................
Second Injury Fund................................................................................
Silicosis and Dust Disease Fund............................................................
Safety Education and Training Fund......................................................

39.
40.
41.
42.
43.

44.

Other assessments. Include a detailed schedule of assessments.........

44.

45.
46.
47.

Total Taxes, Fees and Assessments. Add lines 32 through 44.............. 45.
Retaliatory Amount. Subtract line 45, column B, from column A. If less than zero, enter zero..............................
Total Tax Liability. Add lines 31 and 46. Domestic insurers, enter amount from line 31.......................................

46.
47.

00
00

48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.

Overpayment credited from prior period return.......................................................................................................
Estimated tax payments..........................................................................................................................................
Tax paid with request for extension.........................................................................................................................
Michigan tax withheld or Flow-Through Entity credit...............................................................................................
Workers’ Disability Supplemental Benefit (WDSB) Credit (attach document).........................................................
Amount paid with original return plus additional tax paid after orginal return was filed...........................................
Total Payments. Add line 48 through line 53...........................................................................................................
Overpayment, if any, received on the original return and/or amended return(s).....................................................
Total payments available. Subtract line 55 from line 54..........................................................................................
TAX DUE. Subtract line 56 from line 47. If less than zero, leave blank...................................................................
Underpaid estimate penalty and interest from Form 4899, line 38..........................................................................
Annual Return Penalty (see instructions)................................................................................................................
Annual Return Interest (see instructions)................................................................................................................
PAYMENT DUE. If line 57 is blank, go to line 62. Otherwise add lines 57 through 60............................................

48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.

00
00
00
00
00
00
00
00
00
00
00
00
00
00

62.
63.
64.

Overpayment. Subtract line 47, 58, 59 and 60 from line 54. If less than zero, leave blank (see instructions)............
CREDIT FORWARD. Amount on line 62 to be credited forward and used as an estimate for next tax year..............
REFUND. Subtract line 63 from line 62...................................................................................................................

62.
63.
64.

00
00
00

FEES AND ASSESSMENTS

TOTAL

X X X X X X X X

PAYMENTS AND TAX DUE

OVERPAYMENT, REFUND OR CREDIT FORWARD

Taxpayer Certification.

I declare under penalty of perjury that the information in
this return and attachments is true and complete to the best of my knowledge.

X
X
X
X
X

X
X
X
X
X

X
X
X
X
X

X
X
X
X
X

X
X
X
X
X

X
X
X
X
X

Preparer Certification.

I declare under penalty of perjury that this
return is based on all information of which I have any knowledge.

By checking this box, I authorize Treasury to discuss my return with my preparer.

Authorized Signer’s Name (print or type)
Title

+

0000 2024 40 02 27 4

Preparer’s Business Name (print or type)

Date
Telephone Number

X
X
X
X
X

X X X X X X X X

Preparer’s PTIN, FEIN or SSN
Authorized Signature for Tax Matters

X
X
X
X
X

Preparer’s Business Address and Telephone Number (print or type)

Instructions for an amended Corporate Income Tax return
Forms 4892, 4906 and 4909
Purpose
To calculate and file an amended Corporate Income Tax (CIT)
return.
Standard taxpayers will file the CIT Amended Return (Form
4892); insurance companies will file the Insurance Company
Amended Return for Corporate Income and Retaliatory Taxes
(Form 4906); and financial institutions will file CIT Amended
Return for Financial Institutions (Form 4909).

REASON CODE FOR AMENDING RETURN
Include additional information on a separate sheet
explaining the reason for amending the return.
01

Amended a federal return.

02

Federal audit.

03

Response to a Michigan Notice of Adjustment.

04

Claiming a previously unclaimed credit or payment.

05

Original return missing information/incomplete
form.

06

Correcting information/figures originally reported.

07

Unitary Business Groups:
Adding or deleting member(s).

08

Due to litigation.

09

Partnership Audit Adjustment (PAA)

20

Other.

Amending a Return
To amend a current or prior year annual return, use the amended
return that is applicable for that tax year and taxpayer type.
Include all schedules and attachments filed with the original
return, even if not amending them. Do not include a copy of
the original return with the amended return.
Current and previous tax year forms are available at www.
michigan.gov/treasuryforms.
To amend a return to claim a refund, file within four years of
the due date of the original return (including valid extensions).
Interest will be paid beginning 45 days after the claim is filed
or the due date, whichever is later.
If amending a return to report a deficiency, penalty and interest
may apply from the due date of the original return.
If any changes are made to a federal income tax return that
affect CIT tax base, filing an amended return is required in
accordance with MCL 206.687(2).

Line-by-Line Instructions
In most cases, the lines on the amended return match the lines
on the originally filed return. Unless otherwise noted, use the
instructions for the original return to complete the amended
return. Follow the instructions for the CIT Annual Return
(Form 4891) to complete Form 4892; follow the instructions
for the Insurance Company Annual Return for Corporate
Income and Retaliatory Taxes (Form 4905) to complete Form
4906; and follow the instructions for the CIT Annual Return for
Financial Institutions (Form 4908) to complete Form 4909.
Federal Employer Identification Number (FEIN): The
taxpayer FEIN entered on line 3 must be entered in the
Taxpayer FEIN field at the top of each succeeding page of the
amended form.
Reason code for amending return: Using the following
table, select the two-digit code that best represents the reason
for amending the return. Enter the code in the “Reason code
for amending field” at the top of page 1. Include additional
explanation on a separate sheet of paper and attach it to the
amended return.

Amount paid with original return plus additional tax paid
after original return was filed: Enter all payments made with
the original return and all previous returns for this tax year,
as well as additional payments made after those returns were
filed.
Overpayment, if any, received on the original return and/
or amended return(s): Enter the overpayment received (refund
received plus credit forward created) on the original return and
all previous returns.

Standard Taxpayers Only
“As Originally Filed or Most Recently Amended” and
“Correct Amount”: Where the amended return provides
a Column A titled “As Originally Filed or Most Recently
Amended,” provide the amount that was used on the taxpayer’s
most recent return that the new return will amend. Put the
amended amounts in Column B, “Correct Amount.”
NOTE: On lines 9 through 11, complete only with amended
numbers.

Insurance Companies and Financial Instituions
Insurance Companies will complete all lines of an amended
return using only amended numbers. Financial filers will
complete an amended return with entries for both the original
and amended figures as directed. Taxpayers must file using
the appropriate amended return.

5