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Michigan Department of Treasury (Rev. 07-17), Page 1 of 2 Issued under authority of Public Act 281 of 1967, as amended.

2017 MICHIGAN Individual Income Tax Return MI-1040 Amended Return

(Include Schedule AMD)
Return is due April 17, 2018.
Type or print in blue or black ink. Print numbers like this: 0123456789 - NOT like this: 14
1. Filer’s First Name M.I. Last Name 2. Filer’s Full Social Security No. (Example: 123-45-6789)

If a Joint Return, Spouse’s First Name M.I. Last Name

3. Spouse’s Full Social Security No. (Example: 123-45-6789)
Home Address (Number, Street, or P.O. Box)

City or Town State ZIP Code 4. School District Code (5 digits – see page 60)

5. STATE CAMPAIGN FUND 6. FARMERS, FISHERMEN, OR SEAFARERS

Check if you (and/or your spouse, if a. Filer
filing a joint return) want $3 of your taxes Check this box if 2/3 of your income is from farming,
to go to this fund. This will not increase b. fishing, or seafaring.
Spouse
your tax or reduce your refund.

7. 2017 FILING STATUS. Check one. 8. 2017 RESIDENCY STATUS. Check all that apply.
a. Single * If you check box “c,” complete a. Resident
line 3 and enter spouse’s full name * If you check box “b” or
b. Married filing jointly below: b. Nonresident * “c,” you must complete
and include Schedule
NR.
c. Married filing separately* c. Part-Year Resident *

9. EXEMPTIONS. NOTE: If someone else can claim you as a dependent, check box 9d, enter 0 on line 9a and enter $1,500 on line 9d (see instr.).

a. Number of exemptions claimed on 2017 federal return........................................ 9a. x $4,000 9a. 00

b. Number of individuals who qualify for one of the following special exemptions: deaf,
blind, hemiplegic, paraplegic, quadriplegic, or totally and permanently disabled 9b. x $2,600 9b. 00
c. Number of qualified disabled veterans ................................................................. 9c. x $400 9c. 00

d. Claimed as dependent, see line 9 NOTE above .................................................. 9d. 9d. 00

e. Add lines 9a, 9b, 9c and 9d. Enter here and on line 15 ................................................................................... 9e. 00

10. Adjusted Gross Income from your U.S. Forms 1040, 1040A, 1040EZ or 1040NR (see instructions) ..... 10. 00

11. Additions from Schedule 1, line 9. Include Schedule 1 ............................................................................ 11. 00

12. Total. Add lines 10 and 11 .......................................................................................................................... 12. 00

13. Subtractions from Schedule 1, line 27. Include Schedule 1 .................................................................... 13. 00

14. Income subject to tax. Subtract line 13 from line 12. If line 13 is greater than line 12, enter “0” ............ 14. 00

15. Exemption allowance. Enter amount from line 9e or Schedule NR, line 19............................................. 15. 00

16. Taxable income. Subtract line 15 from line 14. If line 15 is greater than line 14, enter “0” ...................... 16. 00

17. Tax. Multiply line 16 by 4.25% (0.0425) ..................................................................................................... 17. 00

NON-REFUNDABLE CREDITS AMOUNT CREDIT

18. Income Tax Imposed by government units outside Michigan.

Include a copy of the return (see instructions)........................ 18a. 00 18b. 00
19. Michigan Historic Preservation Tax Credit carryforward and/or
Small Business Investment Tax Credit (see instructions) ....... 19a. 00 19b. 00
20. Income Tax. Subtract the sum of lines 18b and 19b from line 17.
If the sum of lines 18b and 19b is greater than line 17, enter “0” ............................................................... 20. 00

+ 0000 2017 05 01 27 5 Continue on page 2. This form cannot be processed if page 2 is not completed and included.
2017 MI-1040, Page 2 of 2
Filer’s Full Social Security Number

21. Enter amount of Income Tax from line 20. .................................................................................................. 21. 00
22. Voluntary Contributions from Form 4642, line 7. Include Form 4642........................................................ 22. 00
23. USE TAX. Use tax due on Internet, mail order or other out-of-state purchases from
Worksheet 1 (see instructions) ................................................................................................................... 23. 00

24. Total Tax Liability. Add lines 21, 22 and 23 ................................................................................... 24. 00
REFUNDABLE CREDITS AND PAYMENTS

25. Property Tax Credit. Include MI-1040CR or MI-1040CR-2 ..................................................................... 25. 00

26. Farmland Preservation Tax Credit. Include MI-1040CR-5 ..................................................................... 26. 00

FEDERAL MICHIGAN

27. Earned Income Tax Credit. Multiply line 27a by 6% (0.06) and
enter result on line 27b. ........................................................... 27a. 00 27b. 00

28. Michigan Historic Preservation Tax Credit (refundable). Include Form 3581. ........................................... 28. 00

29. Michigan tax withheld from Schedule W, line 7. Include Schedule W (do not submit W-2s) ................. 29. 00

30. Estimated tax, extension payments and 2016 credit forward ..................................................................... 30. 00
31. 2017 AMENDED RETURNS ONLY. Taxpayers completing an original 2017 return should skip to line 32.
Amended returns must include Schedule AMD (see instructions).

If you had a refund and/or credit forward on the original return, check box 31a and enter this amount as a
31a. negative number on line 31c.

If you paid with the original return, check box 31b and enter the amount paid with the original return, plus
31b. any additional tax paid after filing, as a positive number on line 31c. Do not include interest or penalty. 31c. 00

32. Total refundable credits and payments. Add lines 25, 26, 27b, 28, 29, 30 and 31c ........................ 32. 00
REFUND OR TAX DUE
33. If line 32 is less than line 24, subtract line 32 from line 24. If applicable, see instructions.

Include interest 00 and penalty 00 ......................... YOU OWE 33. 00

34. Overpayment. If line 32 is greater than line 24, subtract line 24 from line 32 ................................ 34. 00

35. Credit Forward. Amount of line 34 to be credited to your 2018 estimated tax for your 2018 tax return ... 35. 00

36. Subtract line 35 from line 34. ...................................................................................... REFUND 36. 00

DIRECT DEPOSIT a. Routing Transit Number b. Account Number c. Type of Account
Deposit your refund directly to your financial 1. Checking 2. Savings
institution! See instructions and complete a, b
and c.
Deceased Taxpayer. If Filer and/or Spouse died after December 31, 2016, enter dates below. Preparer Certification. I declare under penalty of perjury that
ENTER DATE OF DEATH ONLY. Example: 04-15-2017 (MM-DD-YYYY) this return is based on all information of which I have any knowledge.
Preparer’s PTIN, FEIN or SSN
Filer Spouse

Preparer’s Name (print or type)

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.
Filer’s Signature Date Preparer’s Business Name, Address and Telephone Number

Spouse’s Signature Date

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

Refund, credit, or zero returns. Mail your return to: Michigan Department of Treasury, Lansing, MI 48956
Pay amount on line 33 (see instructions). Mail your check and return to: Michigan Department of Treasury, Lansing, MI 48929

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