Michigan Schedule of Shareholders and Officers*

Schedule of Shareholders and Officers*
4894, 2022 Michigan Corporate Income Tax Schedule of Shareholders and Officers
Attachment 3

Michigan Department of Treasury
4894 (Rev. 03-22), Page 1 of 3

2022 MICHIGAN Corporate Income Tax Schedule of Shareholders and Officers
For all Corporations claiming the Small Business Alternative Credit
Issued under authority of Public Act 38 of 2011.
Taxpayer Name (If Unitary Business Group, Name of Designated Member)

Taxpayer or DM Federal Employer Identification Number (FEIN)

Unitary Business Groups Only: Name of Unitary Business Group Member Reporting on This Form

Member Federal Employer Identification Number (FEIN)

PART 1: QUALIFYING DATA FOR THE SMALL BUSINESS ALTERNATIVE CREDIT.
Complete Part 2 and Part 3 before completing Part 1. See instructions for definition of active shareholder.
1.

Compensation and director fees of active shareholders. Add amounts in Part 2, column L, for each active
shareholder. Enter here and on Form 4893, line 7 .................................................................................................

1.

00

2.

Compensation and director fees of officers. Add amounts in Part 2, column L, for each officer who is not an
active shareholder. Enter here and on Form 4893, line 8.......................................................................................

2.

00

PART 2: SHAREHOLDERS AND OFFICERS.
3. A
Identifying
Number

See instructions.

B

C

D

E

F

G

Name of shareholder (including corporation, trust, partnership,
or family member who is a shareholder through attribution) or officer
(Last, First, Middle)

FEIN or
Social Security Number

Enter
(X) if
an
officer

% Stock
directly owned

% Stock with
attribution

% Stock from Col. F
less any attribution
between two active
shareholders

Percent of stock (not listed above) owned by shareholders (including through attribution) ......................................
who own less than 10% and receive no compensation or directors’ fees

Total:

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0000 2022 18 01 27 7

100

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Continue on Page 2

2022 Form 4894, Page 2 of 3

Taxpayer or DM FEIN
UBG Member FEIN

PART 2: SHAREHOLDERS AND OFFICERS — Continued
3. H
Identifying
Number

I

Dividends
(used to determine
active shareholders)

J

K

Salaries, wages
and director fees

Employee insurance
plans, pensions, etc.

L

Total compensation and director
fees for officers and/or shareholders. Add columns J and K.

M

N

Share of modified
business income/loss

Total shareholder/officer
income. Add columns L and M.

If more space is needed to complete Part 2, include additional copies of Form 4894. Repeat the taxpayer name and FEIN at the top of every copy of
page 1, and carry over the FEIN to the top of page 2. (See instructions.)

IMPORTANT NOTE ON COMPLETING THIS FORM: If filing this form for a short-period return, or if reporting a part-year shareholder or officer:
•

Compensation, director fees, and dividends of each individual must be entered on this form as the actual amount received during the period.

•

For purposes of determining the credit disqualifiers, compensation and director fees must be annualized.

•

For purposes of determining active shareholders, compensation, director fees, and dividends must be annualized.

+

0000 2022 18 02 27 5

Continue on Page 3

2022 Form 4894, Page 3 of 3

Taxpayer or DM FEIN
UBG Member FEIN

PART 3: LIST OF FAMILY MEMBERS AND THEIR CORRESPONDING RELATIONSHIPS

Part 3 is used to report attributable family relationships between individual shareholders. An attributable family relationship is defined as either a
spouse, parent, child, or grandchild. In Part 3, column O, list each individual shareholder from Part 2, using the same Identifying Number references
from Part 2, column A. For each shareholder listed in column O:
• If an attributable family relationship exists with another shareholder, report that other shareholder’s Identifying Number in the appropriate column,
P through S.
•

If no attributable family relationship exists between the shareholder in column O and any other shareholder, enter “X” in column T.

4. O
Identifying
Number

P

Q

R

S

Spouse

Parent

Child

Grandchild

T

Enter (X) if
No Attributable
Relationship

If more space is needed to complete Part 3, include additional copies of Form 4894. Repeat the taxpayer name and FEIN at the top of every copy of
page 1, and carry over the FEIN to the top of page 3. (See instructions.)

+

0000 2022 18 03 27 3

Instructions for Form 4894
Corporate Income Tax (CIT) Schedule of Shareholders and Officers
For all Corporations claiming the Small Business Alternative Credit

Purpose
To	 determine	 eligibility	 of	 corporations	 to	 qualify	 for	 the	
Small	Business	Alternative	Credit	(SBAC).	This form must be
included when filing CIT Small Business Alternative Credit
(Form 4893).
Corporation	means	a	taxpayer	that	is	required	or	has	elected	to	
file	as	a	C	Corporation	under	the	Internal	Revenue	Code	(IRC).	
Corporation	 includes	 a	 Limited	 Liability	 Company	 that	 has	
elected	to	be	taxed	federally	as	a	C	Corporation.

Special Instructions for Unitary Business
Groups (UBGs)
The	 allocated	 income	 disqualifier	 is	 based	 on	 all	 items	 paid	
or	 allocable	 to	 a	 shareholder	 or	 officer	 by	 all	 members	 of	 the	
UBG.	 All	items	 paid	 or	 allocable	to	a	single	 individual	must	 be	
combined	when	calculating	this	disqualifier.

General Instructions
If	claiming	the	SBAC,	complete	this	form	and	include	it	as	part	
of	the	annual	return	to	report:
• Shareholder	 and	 corporate	 officer	 qualifications	 for	 the	
SBAC;
• Compensation	 and	 director	 fees	 of	 active	 shareholders	 and	
all	officers	for	the	computation	of	the	SBAC.
Officer	 means	 an	 officer	 of	 a	 corporation	 including	 all	 of	 the	
following:
(i)	The	chairperson	of	the	board.
(ii)	 The	 president,	 vice	 president,	 secretary,	 or	 treasurer	 of	
the	corporation	or	board.
(iii)	 Persons	 performing	 similar	 duties	 and	 responsibilities	
to	 persons	 described	 in	 subparagraphs	 (i)	 and	 (ii),	 that	
include,	at	a	minimum,	major	decision	making.
Shareholder	 means	 a	 person	 who	 owns	 outstanding	 stock	 in	
a	 corporation	 or	 is	 a	 member	 of	 a	 business	 entity	 that	 files	 as	
a	 corporation	 for	 federal	 income	 tax	 purposes.	 An	 individual	
is	 considered	 the	 owner	 of	 the	 stock,	 or	 the	 equity	 interest	 in	
a	 business	 entity	 that	 files	 as	 a	 corporation	 for	 federal	 income	
tax	 purposes,	 owned	 directly	 or	 indirectly,	 by	 or	 for	 family	
members	as	defined	by	IRC	§	318(a)(1).
A	 family member,	 as	 defined	 by	 IRC	 §	 318(a)(1),	 includes	
spouses,	parents,	children	and	grandchildren.
NOTE:	 Rules	 of	 attribution	 in	 IRC	 §	 318(a)(1)	 do	 not	
differentiate	between	an	adult	and	a	minor	child.
Outstanding stock	 means	 all	 stock	 of	 record,	 regardless	 of	
class,	 value,	 or	 voting	 rights,	 but	 outstanding	 stock	 does	 not	
include	treasury	stock.
All	 attributable	 family	 members	 of	 persons	 directly	 owning	
stock	during	the	tax	year	must	be	listed	in	Parts	2	and	3.

Tax Years Less Than 12 Months
If	 the	 reported	 tax	 year	 is	 less	 than	 12	 months,	 shareholders’	
and	officers’	allocated	income	must	be	annualized	to	determine	
eligibility	 and	 reduction	 percentage.	 Where	 those	 same	
amounts	 are	 reported	 on	 SBAC	 forms,	 they	 are	 reported	 on	
forms	as	actual,	not	annualized,	amounts.
NOTE:	If	a	shareholder	owned	stock	for	less	than	the	entire	tax	
year	 of	 the	 corporation,	 or	 an	 officer	 served	 as	 an	 officer	 less	
than	the	entire	tax	year:
• For	 purposes	 of	 determining	 credit	 disqualifiers	 and	 credit	
reduction,	 compensation	 and	 director	 fees	 must	 be	 annualized.	
The	determination	of	credit	disqualifiers	and	credit	reduction	is	
performed	off-form.
• For	 purposes	 of	 determining	 active	 shareholders,	
compensation,	director	fees,	and	dividends	must	be	annualized.
The	 determination	 of	 active	 shareholders	 is	 performed	 offform.
Annualizing
Where	 annualization	 applies	 (see	 above	 NOTE),	 multiply	 each	
applicable	 amount	 by	 12	 and	 divide	 the	 result	 by	 the	 number	 of	
months	 in	 the	 tax	 year.	 Generally,	 a	 business	 counts	 a	 month	 if	
the	 business	 operated	 for	 more	 than	 half	 the	 days	 of	 the	 month.	
If	 the	 tax	 year	 is	 less	 than	 one	 month,	 consider	 the	 tax	 year	 to	
be	one	month	for	the	purposes	of	the	calculation.
Resources
For	 guidance	 in	 addition	 to	 these	 instructions,	 see	 Revenue	
Administrative	 Bulletin	 (RAB)	 2020-26	 at	 www.michigan.
gov/taxes.

Line-by-Line Instructions
Lines	not	listed	are	explained	on	the	form.	
Taxpayer Name and Account Number:	 Enter	 name	 and	
account	 number	 as	 reported	 on	 page	 1	 of	 the	 CIT Annual
Return	 (Form	 4891).	 Also,	 the	 taxpayer	 Federal	 Employer	
Identification	 Number	 (FEIN)	 from	 the	 top	 of	 page	 1	 must	 be	
repeated	in	the	proper	location	on	pages	2	and	3.
UBGs:	 Complete	 one	 form	 for	 each	 member	 that	 is	 a	
standard	 member	 (i.e.,	 not	 an	 insurance	 company	 or	 financial	
institution).	 Enter	 the	 Designated	 Member	 (DM)	 name	 in	 the	
Taxpayer	 Name	 field	 and	 the	 member	 to	 whom	 the	 schedule	
applies	 on	 the	 line	 below.	 On	 the	 copy	 filed	 to	 report	 the	 DM’s	
data	 (if	 applicable),	 enter	 the	 DM’s	 name	 and	 account	 number	
on	 each	 line.	 Also,	 the	 DM’s	 FEIN	 and	 the	 member’s	 FEIN	
from	 the	 top	 of	 page	 1	 must	 be	 repeated	 in	 the	 proper	 location	
on	pages	2	and	3.
PART 1: QUALIFYING DATA FOR THE SMALL
BUSINESS ALTERNATIVE CREDIT
NOTE: Parts	2	and	3	must	be	completed	before	Part	1.
NOTE:	If	more	than	one	Form	4894	is	included	for	a	filer,	sum	
the	totals	for	lines	1	and	2	on	the	top	form.

35

Line 1:	 Add	 compensation	 and	 director	 fees	 (column	 L)	 of	 all	
active	 shareholders	 and	 enter	 the	 result	 on	 line	 1	 and	 on	 Form	
4893,	 line	 7.	 Report	 on	 line	 1	 and	 on	 Form	 4893,	 line	 7	 actual,	
not	annualized,	amounts.

this	 numbering	 system	 is	 followed.	 All	 shareholders’	 family	
members,	 as	 defined	 by	 IRC	 §	 318(a)(1),	 are	 considered	
shareholders	and	must	be	listed	in	Parts	2	and	3.
See	 definitions	 of	 officer,	 shareholder,	 family	 member,	 and	
outstanding	stock	in	the	general	instructions	for	this	form.

An	active shareholder:
• Is	 a	 shareholder	 of	 the	 corporation,	 including	 through	
attribution,	AND
• Owns	 at	 least	 5	 percent	 of	 outstanding	 stock,	 including	
through	attribution	(column	F	=	5	percent	or	more),	AND
• Receives	 at	 least	 $10,000	 in	 compensation,	 director	 fees,	
or	 dividends	 from	 the	 business	 (sum	 of	 columns	 I	 and	 L	 =	
$10,000	 or	 more).	 Important:	 For	 short-period	 returns	 or	 a	
part-year	 shareholder,	 compensation,	 director	 fees,	 and	
dividends	of	each	individual	must	be	annualized	to	meet	this	
requirement.	Perform	annualized	calculations	off-form.

If	 more	 lines	 are	 needed	 for	 listing	 the	 shareholders	 and	 officers,	
include	 additional	 copies	 of	 this	 form.	 	 Complete	 the	 taxpayer	
name	 and	 account	 number	 on	 each	 copy	 (and	 UBG	 member	 if	
applicable),	 and	 lines	 3	 and	 4	 as	 necessary.		 If	 using	 more	 than	
one	 copy	 of	 the	 form,	 continue	 the	 sequential	 numbering	 system	
for	the	Member	Number	in	columns	A,	H,	and	O.
Columns B and C:	 Identify	 each	 shareholder	 and	 corporate	
officer	 by	 name	 and	 Social	 Security	 number.	 Corporations,	
Trusts,	and	Partnerships	should	be	identified	using	the	FEIN.
NOTE: Column C:	 An	 individual	 or	 foreign	 entity	 that	 does	
not	 have	 a	 Social	 Security	 number	 or	 FEIN	 may	 enter	 in	
Column	C	“APPLD	FOR”	(an	abbreviation	for	“applied	for”)	or	
“FOREIGNUS”	(an	abbreviation	for	“foreign	filer”).

Line 2:	 Add	 compensation	 and	 director	 fees	 (column	 L)	 of	 all	
corporate	officers	who	are	not	active	shareholders	and	enter	the	
result	 on	 line	 2	 and	 on	 Form	 4893,	 line	 8.	 To	 determine	 which	
officers	 are	 not	 active	 shareholders,	 use	 the	 definition	 of	 active	
shareholders	under	line	1.

Column E:	 Enter	 the	 percentage	 of	 outstanding	 stock	 each	
shareholder	 or	 corporate	 officer	 owns	 directly.	 If	 a	 shareholder	
owned	 stock	 for	 a	 period	 less	 than	 the	 corporation’s	 tax	 year,	
multiply	 that	 shareholder’s	 percentage	 of	 ownership	 by	 the	
number	 of	 months	 owned	 and	 divide	 the	 result	 by	 the	 number	
of	months	in	the	corporation’s	tax	year.

PART 2: SHAREHOLDERS AND OFFICERS
Line 3 (Columns A through N):	In	column	A,	assign	numbers	
(beginning	 with	 1)	 to	 all	 shareholders	 and	 officers	 in	 order	
of	 percentage	 of	 stock	 ownership	 (percentage	 in	 column	 G),	
starting	with	the	highest	percentage	first.	Repeat	this	numbering	
in	 Part	 2,	 column	 H,	 and	 Part	 3,	 column	 O.	 It	 is	 essential	 that	

Taxpayers	must	account	for	100	percent	of	the	stock.	If	it	is	not	
accounted	for,	processing	of	the	return	may	be	delayed.

ATTRIBUTION EXAMPLE:
Larry David Stone
Betty Ann Stone
Mary Elizabeth Stone

Husband of Betty Stone, Father of Mary Stone, Stepfather of Tammie Rock, Step Grandfather of Kathy Rock
Daughter of Bob Pebble, Wife of Larry Stone, Mother of Tammie Rock, Stepmother of Mary Stone, Grandmother of Kathy Rock
Daughter of Larry Stone, Stepdaughter of Betty Stone

Tammie Marie Rock

Daughter of Betty Stone, Stepdaughter of Larry Stone, Spouse of Steve Rock, Mother of Kathy Rock, Granddaughter of
Bob Pebble

Steve Carl Rock
Kathy Evelyn Rock
Mike Joseph Rock
Bob Kenneth Pebble
Terry Robert Marble

Spouse of Tammie Rock, Father of Kathy Rock, Brother of Mike Rock
Daughter of Tammie and Steve Rock, Granddaughter of Betty Stone, Step Granddaughter of Larry Stone
Brother of Steve Rock
Father of Betty Stone, Grandfather of Tammie Rock
Friend

Part 2: Shareholders and officers - See instructions

Member
Number

36

B

A

3.

Name of shareholder (including corporation, trust, partnership,
or family member who is a shareholder through attribution) or
officer (Last, First, Middle)

Part 3: List of family members and their corresponding relationship type
O

4.

Member
Number

P
Spouse

1

Stone, Larry David

1

2

2

Stone, Betty Ann

2

1

3

Stone, Mary Elizabeth

3

4

Rock, Tammie Marie

4

5

5

Rock, Steve Carl

5

4

6

Rock, Kathy Evelyn

6

7

Rock, Mike Joseph

7

8

Pebble, Bob Kenneth

8

9

Marble, Terry Robert

9

Q
Parent

R
Child

S

T

Grandchild

Check (X) if
No Attributable
Relationship

3
8

4

6

1
2

6
6

4-5
X
2

4
X

Column F:	 Enter	 the	 percentage	 of	 outstanding	 stock	 each	
shareholder	 owns,	 including	 through	 attribution	 of	 ownership	
from	family	members	under	IRC	§	318(a)(1).

an	 officer	 or	 shareholder.	 These	 amounts	 must	 be	 annualized	
when	 determining	 disqualifiers,	 but	 should	 be	 reported	 as	
actual	amounts	on	this	form.

Column G:	 When	 reporting	 ownership	 of	 a	 person	 who	 is	
an	 active	 shareholder,	 do	 not	 include	 in	 Column	 G	 any	 stock	
ownership	 attributed	 to	 this	 person	 from	 another	 active	
shareholder.	 See	 definition	 of	 active	 shareholders	 in	 the	 Part	 1	
instructions.	 For	 the	 purposes	 of	 determining	 disqualification	
from	 the	 SBAC,	 an	 active	 shareholder’s	 share	 of	 business	
income	is	not	attributed	to	another	active	shareholder.

NOTE:	 All	 insurance	 and	 pension	 payments	 must	 be	 included,	
whether	 or	 not	 the	 shareholder	 or	 corporate	 officer	 worked	 in	
Michigan.

EXAMPLE:	 In	 this	 case,	 the	 husband	 and	 daughter	 are	 active	
shareholders	 because	 their	 total	 compensation,	 director	 fees,	 and	
dividends	 from	 the	 business	 are	 greater	 than	 $10,000	 and	 they	
own	 more	 than	 5%	 of	 stock	 (column	 E).	 The	 wife	 and	 son	 are	
not	 active	 because	 their	 total	 compensation,	 director	 fees,	 and	
dividends	 from	 the	 business	 are	 less	 than	 $10,000	 (even	 though	
they	own	more	than	5%	of	stock).
Stock Percentage
Column E

Column F

Column G

Husband
(active)

40%

100%
70%
(all shareholders) (husband/wife/son)

Wife
(inactive)

10%

100%
(all shareholders)

100%
(all shareholders)

Son
(inactive)

20%

70% (husband/
wife/son)

70%
(husband/wife/son)

Daughter
(active)

30%

80% (husband/
wife/daughter)

40%
(wife/daughter)

Column I:	 Enter	 total	 dividends	 received	 by	 each	 shareholder	
during	the	tax	year	from	this	business	(used	to	determine	active	
shareholders).
Column J:	 Enter	 salaries,	 wages,	 and	 director	 fees	 that	
are	 attributable	 to	 each	 shareholder	 or	 corporate	 officer.	
Compensation	 paid	 by	 a	 professional	 employer	 organization	
to	 the	 officers	 of	 a	 client	 (if	 the	 client	 is	 a	 corporation)	 and	 to	
employees	 of	 the	 professional	 employer	 organization	 who	 are	
assigned	 or	 leased	 to	 and	 perform	 services	 for	 a	 client	 must	
be	 included	 in	 determining	 the	 eligibility	 of	 the	 client	 for	 this	
credit.
NOTE: If	 a	 shareholder	 owned	 stock	 for	 less	 than	 the	 entire	
tax	 year	 of	 the	 corporation,	 or	 an	 officer	 served	 as	 an	 officer	
less	 than	 the	 entire	 tax	 year,	 report	 only	 the	 salaries,	 wages	
and	 director	 fees	 attributable	 while	 serving	 as	 an	 officer	
or	 shareholder.	 These	 amounts	 must	 be	 annualized	 when	
determining	 disqualifiers,	 but	 should	 be	 reported	 as	 actual	
amounts	on	this	form.

Column M:	 Multiply	 the	 percentage	 in	 column	 G	 by	 line	 6	 on	
Form	4893.
UBGs:	 Multiply	 the	 percentage	 in	 column	 G	 by	 the	 sum	 of	
lines	12,	26	and	29	from	the	CIT Data on UBG Members	(Form	
4897).
For Tax Years Less Than 12 Months:	Shareholder	compensation	
must	 be	 annualized	 when	 determining	 disqualifiers,	 but	 should	 be	
reported	as	actual	amounts	on	this	form.
PART 3: LIST OF FAMILY MEMBERS AND THEIR
CORRESPONDING RELATIONSHIPS
Columns	 P	 through	 S	 represent	 relationships	 affected	 by	
attribution.
For	 each	 shareholder	 listed	 in	 Part	 2,	 column	 A,	 enter	 the	
corresponding	 number	 of	 the	 shareholder’s	 spouse,	 parent,	
child,	or	grandchild,	if	any,	listed	in	Part	2,	column	A.
If	 more	 than	 one	 number	 is	 entered	 in	 boxes	 P	 through	 S,	
separate	numbers	with	a	dash.	For	example,	if	a	family	member	
has	 three	 children,	 each	 child’s	 member	 number	 should	 appear	
in	the	“Child”	column	with	dashes	separating	them	(“2-3-4”).
Do	 not	 use	 a	 dash	 to	 imply	 included	 numbers	 (such	 as	 “5-8”	
meaning	 “5	 through	 8”),	 but	 instead	 include	 each	 member	
number	(“5-6-7-8”).	Do	not	use	commas.
EXAMPLE (SEE THE ATTRIBUTION EXAMPLE ON
THE PREVIOUS PAGE):	 Kathy	 Rock’s	 (6)	 parents	 (4	 and	 5)	
work	for	the	company.	Kathy	will	list	“4-5”	in	column	Q.
NOTE:	 If	 the	 space	 provided	 in	 the	 line	 4	 columns	 is	 not	
adequate	to	list	all	of	the	corresponding	relationships,	include	a	
separate	 sheet	 of	 paper	 with	 the	 member	 number	 from	 column	
O,	 the	 corresponding	 relationship,	 and	 the	 number	 of	 the	
member(s)	with	that	relationship.
Column T:	 Check	 column	 T	 for	 each	 shareholder	 for	 whom	
columns	 P	 through	 S	 are	 blank	 (no	 attributable	 relationship	
exists).
Include completed Form 4894 as part of the tax return filing.

NOTE:	All	compensation	must	be	included,	whether	or	not	the	
shareholder	or	corporate	officer	worked	in	Michigan.
Column K: Enter	 employee	 insurance	 payments	 and	 pensions	
that	are	attributable	to	each	shareholder	or	officer.
NOTE: If	a	shareholder	owned	stock	for	less	than	the	entire	tax	
year	 of	 the	 corporation,	 or	 an	 officer	 served	 as	 an	 officer	 less	
than	 the	 entire	 tax	 year,	 report	 only	 the	 employee	 insurance	
payments,	 pensions,	 etc.,	 that	 are	 attributable	 while	 serving	 as	

37