165, Annual Return For Sales, Use And Withholding Taxes 165 2013 Fillable 442458 7
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Reset Form Michigan Department of Treasury 165 (Rev. 07-13) Annual Return for Sales, Use and Withholding Taxes Check box if this is an amended return. Issued under authority of Public Act 167 of 1933. Taxpayer's Business Name Account Number Return Year Amended Return Date Due Amendment Date File this return by February 28. Do not use this form to replace a monthly or quarterly return. A. Use Tax: Sales & Rentals B. Sales Tax 6% 6% Sales and Use Tax 1. Gross sales (including sales by out-of-state vendors subject to use tax)....... 1. 2. Rentals of tangible property and accommodations........................................ 2. 3. Telecommunications services......................................................................... 3. 4. Add lines 1, 2, and 3 ...................................................................................... 4. 5. ALLOWABLE DEDUCTIONS (i) a. Resale............................................................................................................5a. (i) b. Industrial processing or agricultural producing............................................... b. (i) c. Interstate commerce....................................................................................... c. (i) d. Exempt services............................................................................................. d. (i) e. Sales on which tax was paid to Secretary of State........................................ e. (i) f. Food for human/home consumption............................................................... f. (i) g. Bad debts....................................................................................................... g. (i) h. Michigan motor fuel or diesel fuel tax............................................................. h. (i) i. Other. Identify: ____________________________....................................... i. (i) j. Tax included in gross sales (line 1)................................................................ j. k. Total allowable deductions. Add lines 5a - 5j.................................................. k. 6. Taxable balance. Subtract line 5k from line 4................................................. 6. 7. Tax Rate......................................................................................................... 7. 8. Gross tax due. Multiply line 6 by line 7........................................................... 8. (i) 9. Tax collected in excess of line 8..................................................................... 9. 10. Add lines 8 and 9............................................................................................10. (i) 11. TOTAL discount allowed (see instructions)...............................................11. 12. Total tax due. Subtract line 11 from line 10.....................................................12. (i) 13. Tax payments in current year (after discounts)..............................................13. 1. 2. 3. 4. 5a. b. c. d. e. f. g. h. i. j. k. 6. x .06 7. 8. 9. 10. 11. 12. 13. x .06 Use Tax on Items Purchased for Business or Personal Use * x .06 = 14b. (i) 14. Enter your taxable purchases......................................................... 14a. (i) 15. Tax payments made in the current year.............................................................................................................. 15. . Withholding Tax (i) 16. Gross Michigan payroll, pension, and other taxable compensation for the year................................................. 16. (i) 17. Number of W-2, and 1099 forms enclosed ........................................ 17. (i) 18. Total Michigan income tax withheld per W-2 and 1099 forms............................................................................. 18. 19. Total Michigan income tax withholding paid during current tax year................................................................... 19. Summary 20. Total sales, use and withholding taxes due. Add lines 12A, 12B, 14b and 18..................................................... 21. Total sales, use and withholding taxes paid. Add lines 13A, 13B, 15 and 19...................................................... 22. 22. If line 21 is greater than line 20, enter overpayment ......................... 23. Amount of line 22 to be credited forward on your account. 23. We will notify you when your credit is verified and available.............. 24. (i) 24. Amount of line 22 to be refunded to you............................................ (i) 25. If line 21 is less than line 20, enter balance due................................................................................................. (i) 26. If this return is filed late, enter penalty and interest. (See instructions.).............................................................. 27. TOTAL PAYMENT DUE. Add lines 25 and 26. Make check payable to "State of Michigan."........................... 20. 21. 25. 26. 27. * Use Tax on Items Purchased for Business or Personal Use: Use lines 14 and 15 to report purchases made for use in your business or for items removed from your inventory for personal or business use. Do not repeat the amounts from Column A, lines 1 - 4 here. Form 165, Page 2 Taxpayer's Business Name Account Number Type of Business Ownership (check one only) Individual Husband - Wife General Partnership Limited Partnership Michigan Corporation Subchapter S Non-Michigan Corporation Subchapter S Trust or Estate (Fiduciary) Joint Stock Club or Investment Company Social Club or Fraternal Organization Other (Explain) Limited Liability Company Taxed As: Individual Partnership C Corporation S Corporation Disregarded Entity Enter the reason for amending return. Include your account number on each page being submitted. (Required) Signature (you are required to complete all information requested below) I declare under penalty of perjury that this return is true and complete to the best of my knowledge. By checking this box, I authorize Treasury to discuss my return with the designated preparer. Signature of Taxpayer's Offical Representative (must be an Owner, Officer, Member, Manager, or Partner) Print Offical Representative's Name Date Offical Representative's Title (Owner/Officer/Member/Manager/Partner) (Required) Telephone Number I declare under penalty of perjury that this return is based on all information of which I have any knowledge. Designated Preparer's Signature, Address, Telephone and ID Number Taxpayer's FEIN or Social Security Number Mailing Instructions: If sending an amended annual return, check the amended return box on page 1 of this return, and refer to page 6 of the SUW Instruction Book (Form 78) for amended return mailing addresses and other instructions. If enclosing payment with your annual return, mail to: Michigan Department of Treasury Department 78172 P.O. Box 78000 Detroit, MI 48278-0172 If requesting a credit to your account (amount on line 23) or a refund (amount on line 24), mail to: Michigan Department of Treasury P.O. Box 30779 Lansing, MI 48909 If no payment is enclosed with your annual return, mail to: Michigan Department of Treasury Lansing, MI 48930 www.michigan.gov/bustax is a secure Web site designed specifically to protect your tax information. Use this Web site to check the status of your Sales, Use, and Withholding transactions and ask specific questions about your account.
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