FINAL VERSION PUBLISHED ON NOVEMBER 20, 2015...2016 WITHHOLDING TAX COMMON FORM SPECIFICATIONS PACKET FINAL VERSION PUBLISHED ON NOVEMBER 20, 2015 This document contains the final

2016 WITHHOLDING TAX COMMON FORM

SPECIFICATIONS PACKET FINAL VERSION PUBLISHED ON

NOVEMBER 20, 2015

This document contains the final version of the Withholding Tax Common Form and Specifications packet authorized by the following Michigan cities levying a city income tax and accepting withholding tax returns using the common form format: Albion, Battle Creek, Big Rapids, Flint, Grand Rapids, Hamtramck, Highland Park, Ionia, Jackson, Lansing, Lapeer, Muskegon, Pontiac, Port Huron, Portland, Saginaw, Springfield, and Walker. These forms are issued pursuant to the Michigan Uniform City Income Tax Ordinance MCL 141.671. As other Michigan cities levying an income tax approve acceptance of withholding tax returns using the withholding tax common form format, notifications will be sent to software companies. A listing of updates, changes and corrections to the 2015 version of the forms, schedules and appendices is found starting on page 64 of this packet. Paper submission of questions and return forms approval can be mailed to:

John Schaut, Income Tax Administrator City of Grand Rapids Income Tax Department

300 Monroe Ave NW Suite 380 Grand Rapids MI 49503

Electronic submission of questions and return forms approval can be e-mailed to:

John Schaut, Income Tax Administrator [email protected]

TABLE OF CONTENTS Revised 10/05/2015

Page 1 Title Page Page 2 Table of Contents Page 4 Instructions for Software Companies

Page 4 Michigan Cities Levying an Income Tax Page 4 Michigan Cities Accepting Common Withholding Tax Forms Page 4 Michigan Cities Not Accepting Common Withholding Tax Forms Page 4 General Information Page 5 Governance Page 5 2016 Common Withholding Tax Forms, Schedules and Worksheets Page 5 Listing of Appendices Page 6 Approval of Forms Page 6 Submission of Written Questions or Printed Sample Forms Page 6 Electronic Submission of Questions or Sample Returns Page 5 Printing in Margins Page 6 Printing of Forms Page 6 Extension of Time to File Withholding Tax Return

Page 7 Withholding Tax Guide Page 7 Who Must Withhold Page 7 Withholding as a Convenience to Employee Page 7 Registration Page 8 From Whom To Withhold Page 8 Forms CF-W-4 Required Page 9 From What Compensation to Withhold Page 9 Payments Not Subject to Withholding Page 9 Income Tax Rates Page 10 Calculating the amount to Withhold Page 10 Computer Preparation of Payroll Page 11 Resident Employee Who Works in another City Page 11 Nonresident – Job Partly in a City Levying an Income Tax Page 11 Nonresident – Predominate Place of Employment Page 12 Payment of Tax Withheld Page 12 Employer’s Monthly Deposit for the First or Second Month of a

Quarter Page 12 Form CF-941- Employer’s Quarterly Return Page 12 Mailing Addresses for Mailing Withholding Tax Returns Page 12 Due Dates Page 13 Correction of Errors Over or Under Reporting Tax Withheld Page 13 Correction of Form W-2 Errors Over or Under Reporting Income Page 13 Annual Reports Page 14 Sale or Discontinuance of Business Page 14 Forms, Instructions and Information Page 14 Disclaimer Notice

Page 15 Employer’s Withholding Tax Forms and Instructions Page 15 General Instructions Page 15 Who is Required to Withhold Page 15 Withhold at the Following Tax Rates Page 16 Listing of Forms, Instructions and Monthly and Quarterly Due Dates Page 17 Form CF-6-IT, Notice of Change or Discontinuance Page 18 Forms CF-501 and CF-941, First Quarter Withholding Tax Forms

2016 COMMON INCOME TAX WITHHOLDING FORMS (FINAL VERSION)

Printed 11/20/2015 Page 2 of 66

Page 19 Forms CF-501 and CF-941, Second Quarter Withholding Tax Forms

Page 20 Forms CF-501 and CF-941, Third Quarter Withholding Tax Forms Page 21 Forms CF-501 and CF-941, Fourth Quarter Withholding Tax Forms Page 22 Instructions for Forms CF-501 and CF-941 Page 23 Form CF-W-3, Employer’s Annual Reconciliation of Income Tax

Withheld Page 24 Form CF-W-3S, Supplement to Employer’s Annual Reconciliation

of Income Tax Withheld Page 25 Instructions for Form CF-W-3, Employer’s Annual Reconciliation of

Income Tax Withheld and Form CF-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld

Page 27 Penalty and Interest Worksheet Page 25 Other Withholding Tax Forms

Page 28 Form CF-SS-4, Withholding Tax Registration Page 21 Instructions for Form CF-SS-4 Page 33 Form CF-2678, Employee/Payor Appointment of Agent Page 35 Instructions for Form CF-2678, Employee/Payor Appointment of

Agent Page 36 Form CF-8655, Reporting Agent Authorization Page 37 Instructions for Form CF-8655, Reporting Agent Authorization Page 38 Form CF-W-4, Employee’s Withholding Certificate Page 39 Form 2848, Power of Attorney Authorization Page 40 Instructions for Form CF-2848, Power of Attorney Authorization

Page 41 Appendices Page 41 Appendix A, Withholding Deposit Requirements Page 42 Appendix B, Exemption Amounts and Tax Rates for 2015 Page 43 Appendix C, Personal Exemptions Allowed for 2015 Page 44 Appendix D, Approved City Name Abbreviations to Use for

Completing Form W-2, Box 20 Page 45 Appendix E, Mailing Addresses for Mailing Withholding Tax Returns Page 46 Appendix F, Withholding Tax Contacts for Michigan Cities Levying

a City Income Tax Page 47 Appendix G, OCR Line Specifications for Withholding Tax Return

forms CF-501, CF-941 or CF-W-3 Page 51 Appendix H, Three Character City Name Abbreviation Page 52 Appendix I, Tax ID Check Digit Specifications Page 53 Appendix J, Cities Accepting ACH Debit or Credit Withholding

Payments and Return Filing and Cities Accepting Forms W-2 using Common Form CD-ROM Format

Page 54 Appendix K, Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance and the Regulations Adopted by Most Michigan Cities

Page 58 Appendix L, Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance

Page 64 Updates, Changes and Corrections to Appendices, Forms, Schedules and Worksheets Page 64 Updates, Changes and Corrections to Appendices, Forms,

Schedules and Worksheets



2016 COMMON FORM - INCOME TAX WITHHOLDING

INSTRUCTIONS FOR SOFTWARE COMPANIES

Michigan Cities Levying an Income Tax Twenty-two Michigan cities impose a city income tax. All Michigan cities imposing an income tax must adopt the Michigan Uniform City Income Tax Ordinance, MCL 141.601 et seq.

Michigan Cities Accepting the 2016 Common Withholding Tax Forms Nineteen Michigan cities accept the Common Form format for computer software prepared withholding tax returns for 2016:

Battle Creek Highland Park Muskegon Saginaw Big Rapids Ionia Muskegon Heights Springfield Flint Jackson Pontiac Walker Grand Rapids Lansing Port Huron Hamtramck Lapeer Portland

Michigan Cities Not Accepting the 2016 Common Withholding Tax Forms Albion Detroit Grayling Hudson

General Information These instructions are to be used with the 2016 common withholding tax forms contained in this packet. Additional information may be provided on the individual forms, form instructions or worksheets. As additional cities agree to accept the common withholding tax forms and when changes or corrections are made to the forms, instructions or appendices, a notice will be sent through Creative Solutions, the Michigan representative for the National Association of Computerized Tax Processors (NACTP). Creative Solutions will then distribute the information to its members. Since the Internal Revenue Code was amended relative to professional employee organizations (PEO’s) effective January 1, 2016, Form CF-SS-4, Employers Withholding Registration, has been revised and new Forms CF-2678, Employer/Payor Appointment or Agent, and CF-8655, Reporting Agent Authorization have been added. The cities are, in essence, following the IRC relative to registering as an employer for income tax withholding and for filing returns and paying city income tax withheld. The cities need to know: which employers are liable for withholding; which employers are using a reporting agent to file the employer’s withholding tax returns and who the agents are; which employers are using a payor agent who files and pays the employer’s withholding tax returns under the agent’s FEIN; and which employers use a PEO and what the PEO’s responsibilities are under the PEO agreement. Form CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld, has been revised and reformatted to include the client employer’s name and FEIN when the Form CF-W-3 is filed under the withholding agent’s or CPEO’s FEIN. A new Form CF-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld, has been added. Form CF-W-3S is to be filed with form CF-W-3 when either or both of the following conditions exist: the withholding tax has been paid under more than one FEIN; and/or the related Forms W-2 are filed under more than one FEIN.



Governance Each city accepting common form withholding tax returns retains governance relative to administration of their city’s Income Tax Ordinance including, but not limited to exemptions, renaissance zone designation, etc. Please refer to the appendices for additional information pertinent to each city. The appendices have been updated to include changes and corrections for 2016.

2016 Common Withholding Tax Forms, Schedules and Worksheets Listing of Withholding Tax Guide, Forms and Worksheets Withholding Tax Guide Form CF-SS-4, Employer’s Withholding Registration Form CF-2678, Employer/Payor Appointment of Agent Form CF-8655, Reporting Agent Authorization Employer’s Withholding Tax Forms and Instructions Booklet General Instructions Listing of Withholding Tax Forms in Booklet and Due Dates for Monthly (Form CF-

501) Deposits and Quarterly (Form CF-941) Returns Form CF-6-IT, Notice of Change or Discontinuance Forms CF-501 and Form CF-941, First Quarter Withholding Tax Forms Forms CF-501 and Form CF-941, Second Quarter Withholding Tax Forms Forms CF-501 and Form CF-941, Third Quarter Withholding Tax Forms Forms CF-501 and Form CF-941, Fourth Quarter Withholding Tax Forms Form CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld Form CF-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax

Withheld Instructions for forms CF-501, Employer’s Monthly Deposit of Income Tax Withheld

and Form CF-941, Employer’s Quarterly Deposit of Income Tax Withheld Penalty and Interest Worksheet

Form CF-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld

CF-W-4, Employee’s Withholding Certificate CF-2848, Power of Attorney Authorization

Listing of Appendices Appendix A, Cities Accepting Common Form Withholding Tax Returns, Exemption

Amounts and Tax Rates for Tax Year 2016 Appendix B, Personal Exemptions Allowed Appendix C, Withholding Deposit Requirements Appendix D, Authorized City Name Abbreviations to Use for Completing Form W-2, Box

20, Locality Name and Related RS Record Data for EFW2 Transmittals Appendix E, Three Character City Name Abbreviation Mailing Addresses for Mailing Withholding Tax Returns Appendix F, Cities accepting ACH Debit or Credit Withholding Payments and Return

Filing and Cities Accepting Forms W-2 using Common Form CD-ROM Format

Withholding Tax Contacts for Michigan Cities Levying a City Income Tax Appendix G, Mailing Addresses for Mailing Returns to Cities Accepting the Withholding

Tax Common Form Appendix H, Withholding Tax Contacts for Michigan Cities Levying a City Income Tax Appendix I, OCR Line Specifications for Withholding Tax Return forms CF-501, CF-941

or CF-W-3



Appendix J, Tax ID Check Digit Specifications Appendix K, Specifications for Employer Electronic Media Filing of City Forms W-2 Appendix L, Withholding Tax Sections of the Michigan Uniform City Income Tax

Ordinance and the Regulations Adopted by Most Michigan Cities

Approval of Forms The Common Form as produced by software must be submitted for approval to the Income Tax Administrator of the City of Grand Rapids. The Income Tax Administrator for the City of Walker is the backup person for forms approval. For 2016, submission of completed set sample forms for a scanning test is required. Test data for sample forms will be provided as soon as possible.

Submission of written questions or sample returns can be mailed to: John Schaut, Income Tax Administrator City of Grand Rapids Income Tax Department

300 Monroe Ave NW Suite 380 Grand Rapids, MI 49503 Phone: (616) 456-3823 Fax: (616) 456-4540 E-mail: [email protected]

Electronic submission of questions or sample returns can be e-mailed to: John Schaut, Income Tax Administrator E-mail: [email protected]

Printing in Margins The printing of any information including taxpayer, preparer identification, firm identification and/or account information in the left, right, top and bottom margins of any return form, worksheet, schedule or voucher submitted to a city for processing is absolutely prohibited.

Printing of Forms The following forms are to be printed as laid out in the forms packet: CF-501, Employer’s Monthly Deposit of Income Tax Withheld

CF-941, Employer’s Quarterly Return of Income Tax Withheld CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld CF-SS-4, Employer’s Withholding Registration CF-W-4, Employee’s Withholding Certificate CF-2848, Power of Attorney Authorization

Extension of Time to File a Withholding Tax Return No extensions of time are allowed relative to filing a return and making payment of income tax withheld.

Revised 10/15/2015



WITHHOLDING TAX GUIDE

FOR MICHIGAN CITIES LEVYING AN INCOME TAX AND ACCEPTING COMMON FORM WITHHOLDING TAX RETURNS

Revised 10/15/2015

WHO MUST WITHHOLD An employer who: has a location in the city; or is “doing business” in the city, even though the employer has no location in the city; is required to withhold the city’s income tax from wages paid to employees. An employer is any “individual, partnership, association, corporation, nonprofit organization, governmental body or unit or agency, or any other entity that employs one or more persons on a salary, bonus, wage, commission or other basis, whether or not the employer is in a business.” Starting January 1, 2016 as a result of an amendment to IRC Sec. 3511(a)(1), a professional employer organization (PEO):

1. Who is recognized by the Internal Revenue Service (IRS) as a certified professional employer organization (CPEO);

2. Has a PEO agreement with a client employer: a. Who has a location in the city or is “doing business” in the city; b. Under which the PEO is responsible for withholding and paying income tax withheld from

the client’s employees; 3. Meets the definition of employer under the Michigan Uniform City Income Tax Ordinance (MCL

141.606(2)); 4. Is considered to be a co-employer of the employees covered by the PEO agreement and the

client is also considered to be a co-employer of such employees. 5. Is responsible for withholding the city income tax from wages paid to employees; and 6. Is liable for filing returns and payment of the income tax withheld or the income tax that should

have been withheld from employee wages. Example: A construction company from Ohio doing work in a city levying an income tax is required to withhold tax for that city even though it has no business location in the city. An employer who is required to withhold tax for a city must withhold tax from all employees working in that city and from all residents of that city working anywhere for that employer. A nonprofit organization in the city is required to withhold from its employees (even though it is not engaging in business activity in the usual sense).

WITHHOLDING AS A CONVENIENCE TO EMPLOYEE Cities levying an income tax encourage employers not required to withhold tax to register and withhold for the convenience of their employees who are residents of that city. Convenience withholders must comply with the registration and filing requirements of that city’s Income Tax Ordinance.

REGISTRATION Every employer required to withhold income tax for a city must register by filing Form CF-SS-4, Employer’s Withholding Registration with the city. The registration requirement applies to a CPEO responsible for withholding city income tax under an agreement with an employer who has a location in the city or is “doing business” in the city. The employer’s account number is their federal employer identification number (FEIN) followed by an uppercase W. An employer must immediately advise the city of a newly assigned FEIN by filing a Notice of Change or Discontinuance, Form CF-6-IT.



Employers using a reporting agent, an IRC Section 3504 Agent, or a PEO must file additional forms to provide information and disclosure of information to the payroll service provider. Reporting Agent and Form CF-8655 Employers using a reporting agent must file Form CF-8655, Reporting Agent Authorization, with the city to authorize the reporting agent to: sign and file withholding tax returns; make deposits and payments of withholding tax; receive or request copies of tax information and other communications from the city income tax department; and receive otherwise confidential taxpayer information from the city to assist in responding to certain city income tax notices relating to the Form W-2 series of information returns. The employer’s withholding tax is paid and all withholding tax forms are filed under the employer’s FEIN. An employer using this type of reporting agent is solely liable for the filing of withholding tax returns and payment of the withholding tax due. IRC Section 3504 Agent and Form CF-2678 An employer and a third party may file Form CF-2678, Employer/Payor Appoint of Agent, to authorize the third party as an agent of the employer under IRC section 3504, and for the third party to accept the appointment and become the employer’s agent. Under this section of the IRC, the employer is authorizing the city income tax department to disclose otherwise confidential tax information to the agent relating to the authority granted under this appointment, including disclosures required to process Form CF-2678. The agent may contract with a third party, such as a reporting agent or certified public accountant, to prepare or file the returns covered by this appointment, or to make any required deposits and payments. Such contract may authorize the city income tax department to disclose confidential tax information of the employer/payer and agent to such third party. If a third party fails to file the returns or make the deposits and payments, the agent and employer/payer remain liable. Professional Employer Organization PEO Prior to January 1, 2016 there is only one type of PEO, depending on the agreement with their client employer, which may or may not be a payroll service provider, a reporting agent or an IRC Section 3504 agent. After December 31, 2015 there are two types of PEOs. A certified PEO, one certified under IRC Sec. 3511(a)(1), and an uncertified PEO. Information about a CPEO is found at the beginning of this booklet under the heading, “Who Must Withhold.” An uncertified PEO is like all PEOs prior to January 1, 2016 as noted in the above paragraph. A completed registration, Form CF-SS-4, may be filed via E-mail, Fax or U.S. Mail. The e-mail address and Fax number for each city is listed in Appendix H. The mailing address for each city is found in Appendix G.

FROM WHOM TO WITHHOLD Employers are required to withhold from the following employees:

1) All residents of the city whether or not they work in the city; and 2) All nonresidents of the city who have the city as their predominant place of employment (see

below). An employee is defined as “a person from whom an employer is required to withhold for either federal income tax or social security taxes” (MCL141.606(1).

FORM CF-W-4 REQUIRED To determine each employee’s place of residence and predominant place of employment, an employer must have each employee fill out an Employee’s Withholding Certificate, Form CF-W-4. Only one Form CF-W-4 is required for each employee, even though the employee may be subject to withholding for two cities.



When properly filled out, Form CF-W-4 provides the employee’s city of residence and the two cities or communities in which the employee earns the greatest percentage of compensation from the employer. Most employees will only have one city of employment and will check the box indicating 100% as the percentage of compensation earned in that city. Form CF-W-4 is also the employee’s statement of the number of personal and dependency exemptions claimed. Form CF-W-4 is available on the city’s website. The website address for each city is listed in Appendix H. If an employee fails or refuses to complete Form CF-W-4 upon the request of the employer, tax shall be withheld from the employee’s compensation at the city’s resident tax rate. If the information submitted by an employee is not believed to be true, correct and complete, the city income tax department must be advised. Do not mail CF-W-4 forms to the city; these are for the employer’s use and must be retained in the employer’s files.

FROM WHAT COMPENSATION TO WITHHOLD The Michigan Uniform City Income Tax Ordinance requires income tax be withheld from:

1) All compensation (salaries, wages, commissions, severance pay, bonuses, etc.) of a resident employee for services rendered or work performed regardless of whether such services or work are performed in or out of the city; and

2) All compensation of a nonresident employee for services rendered or work performed in the city where the city is the employee’s predominant place of employment.

Vacation, holiday, sick, severance, bonus, etc. pay paid to a nonresident employee who performs part but not all of their work or services in the city are taxable to the same extent that their normal compensation is taxable. Example: A nonresident employee who is subject to withholding on 60% of their earnings, because 60% of their work is performed in a city levying a income tax, is also subject to withholding on 60% of their vacation, holiday, sick pay, severance pay, bonus, etc. pay. Wage payments during periods of sickness are also taxable.

PAYMENTS NOT SUBJECT TO WITHHOLDING Withholding does not apply to:

1) Wages paid to domestic help; 2) Fees paid to independent contractors who are not employees; 3) Payments to nonresident employees for work or services performed in the city, if the

predominant place of employment is not in that city; 4) Payment to a nonresident employee for work or services rendered outside of the city; 5) Pensions, annuities, worker’s compensation and similar benefits; 6) Amounts paid for sickness, personal injury or disability (so called excludable sick pay) to the

same extent that these amounts are exempt from federal income tax, but the employer must withhold from such payments if federal tax is withheld;

7) Amounts paid to an employee as reimbursement for expenses incurred in performing services. An individual with income described in items 1, 2 and 3 above is not subject to withholding on such income. The individual is nevertheless required to file an annual return and report such income if the individual is a resident of a city levying an income tax, or is a nonresident earning such income in a city levying an income tax. INCOME TAX RATES The resident and nonresident tax rates for each city are listed in Appendix A.



CALCULATING THE AMOUNT TO WITHHOLD The amount of city income tax to withhold is a straight percentage on compensation after an adjustment for personal and dependency exemptions. The personal exemptions allowed by each city are listed in Appendix B. The dependency exemptions allowed by each city are the same as allowed for federal income tax purposes except that some cities allow an individual who may be claimed as an exemption by another taxpayer to claim their own personal exemption. The value of one exemption for each city is listed in Appendix A. For the various pay periods the exemption value is divided by the number of pay periods in a year. Some examples follow:

Exemption Value $600.00 ` $700.00 $750.00 $1,000.00 $3,000.00 Weekly (52) $11.54 $13.46 $14.42 $19.23 $ 57.69 Bi-weekly (26) $23.08 $26.92 $28.85 $38.46 $115.38 Semi-monthly (24) $25.00 $29.17 $31.25 $41.67 $125.00 Monthly (12) $50.00 $58.33 $62.50 $83.33 $250.00 Per diem (365) $ 1.64 $ 1.92 $ 2.05 $ 2.74 $ 8.22

Personal exemptions are allowed for the employee and spouse. Additional personal exemptions are allowed by most cities for an employee or spouse who is: 65 years of age or older; blind (this is different from the federal rule); deaf; .or permanently disabled. An employee or spouse who is 65 years of age or older may not claim the additional personal exemption for being permanently disabled. See Appendix B for a listing of personal exemptions allowed by each city. The cities of Albion, Big Rapids, Detroit, Highland Park and Pontiac do not allow a taxpayer to claim a personal exemption if the taxpayer is claimed as an exemption by another taxpayer on that city's income tax return. Dependency exemptions are allowed to the same extent allowed for federal income tax purposes. The amounts in the preceding table are used to adjust gross pay for payroll withholding. The adjustment is the number of exemptions on Form CF-W-4 multiplied by the exemption value of the city. For a weekly payroll for an employee with three (3) exemptions working in a city with an exemption value of $600, the adjustment is 3 times $11.54, or $34.62. EXAMPLE: Gross pay is $200.00 per week and the employee is a resident of Grand Rapids with 3 exemptions. The amount from which tax is to be withheld is $200.00 (gross pay) less $34.62 (exemption amount) or $165.38. Apply the 1.5% resident tax rate (.015 times $165.38) and withhold $2.48 from the employee for this week’s compensation. For bonuses or other taxable earnings paid in addition to regular payroll, do not adjust for exemptions. Withhold the correct tax percentage from the entire bonus or other taxable earnings amount. The above method is applicable to all withholding for regular payrolls. Withholding tax tables for each city are found on each city’s website. Refer to Appendix H for a listing of each city’s website address.

COMPUTER PREPARATION OF PAYROLL Since hardware and software used to compute income tax withholding varies, it is impossible to give an actual program with which to compute withholding. The following is a description of the most commonly used method to compute the amount of tax to withhold.

1. Nonresident employee withholding calculation a. Compute the employee’s gross wages from which to withhold:

i. Use gross earnings of the employee for work performed in the nonresident city; or ii. Use total gross earnings for the payroll period multiplied by the percent earned in the

nonresident city; b. Multiply the employee’s number of exemptions by the appropriate exemption value for the

city for the payroll period:



c. Subtract the result of Step b from the result of Step a. d. Compute the amount of tax to withhold by multiplying the result from Step c by the

nonresident tax rate for the city. 2. Resident employee withholding calculation

a. Compute the employee’s gross earnings for the payroll period. b. Multiply the employee’s number of exemptions by the appropriate exemption value for the

city for the payroll period; c. Subtract the result of Step b from the result of Step a; d. Multiply the result from Step c by the resident tax rate for the city. e. If the employee worked in another city levying an income tax compute the credit for tax

withheld for the other city; (This credit cannot exceed the amount of tax which would be withheld by the resident city using the nonresident tax rate of the resident city on the same amount of gross earnings of the employee for work performed in the nonresident city.)

f. Compute the amount of tax to withhold by subtracting the result of Step e from the result of Step d.

RESIDENT EMPLOYEE WHO WORKS IN ANOTHER CITY LEVYING AN INCOME TAX When an employee who is a resident of a city levying an income tax works at a job in another city levying a city income tax, the employer must withhold separately for both cities. The amount of income tax to withhold for the resident city depends on the credit allowed for the tax withheld for the other city. If the nonresident tax rate of the other city is less than or equal to the nonresident tax rate of the resident city, the amount to withhold for the resident city is calculated by computing the normal resident city withholding and then subtracting the amount of tax withheld for the other city. If the nonresident tax rate of the other city is greater than the nonresident tax rate of the employee’s resident city, the amount to withhold for the employee’s resident city is calculated by computing the normal resident city withholding and then subtracting an amount calculated by multiplying gross pay taxable in the other city by the resident city’s nonresident tax rate.

NONRESIDENT – JOB PARTLY IN A CITY LEVYING AN INCOME TAX If a nonresident of the city works less than 100% of the time within the city for an employer, the amount withheld should be based only on wages earned in the city. If gross pay is $200.00 and only 60% of the employee’s work is in city, the gross pay for the city’s tax purposes is 60% of $200.00 or $120.00. In this example, compute the amount to be withheld for the nonresident city as if the employee earned $120.00 gross pay. NONRESIDENT – PREDOMINANT PLACE OF EMPLOYMENT A nonresident of a city levying an income tax is subject to withholding only when the city is the nonresident employee’s predominant place of employment. The Ordinance defines predominant place of employment as “that city imposing a tax under a uniform city income tax ordinance other than the city of residence, in which the employee estimates he will earn the greatest percentage of his compensation from the employer, which percentage is 25% or more.” See example below. A city is a nonresident’s predominant place of employment if:

1) The nonresident employee earns a greater percentage of his or her compensation in the city than any other city levying an income tax, except the employee’s city of residence; and

2) This greater percentage of his or her compensation in the city constitutes 25% or more of the nonresident employee’s total compensation from the employer.



PAYMENT OF TAX WITHHELD Monthly or quarterly deposit (payment) of the tax withheld may be made in the following ways:

1. Via U.S mail or courier with the filing of a monthly or quarterly withholding tax return form; 2. Many cities accept payments via ACH debit using the city’s withholding tax tool; 3. Many cities accept payments using ACH credit with an addendum file through the employer’s

bank. 4. Some cities accept withholding tax payments via credit card.

For cities accepting ACH direct debit payments, instructions are available on the city’s website. For cities accepting ACH credit payments, registration is required and a set up by the city’s income tax department (or division) is necessary. For cities accepting credit card payments, contact the city for instructions. See Appendix H for a listing of each city’s withholding tax: telephone number; fax number; website address; e-mail address; and contact person. Monthly and quarterly payment forms are available on the city’s website. See Appendix H for a listing of each city’s website address. Most cities do not mail withholding forms to employers. If withholding tax forms are needed, contact the Withholding Tax Section of the city. Most cities provide pre-identified withholding tax forms through use of their Withholding Tax Tool. Refer to the city’s website to see if and how to get pre-identified forms. EMPLOYER’S MONTHLY DEPOSIT FOR THE FIRST OR SECOND MONTH OF A QUARTER Many cities require monthly deposit of tax withheld for the first or second month of a quarter in which the tax withheld for the month exceeds $100.00. Employers who make a deposit for a month must use Form CF-501, Employer’s Monthly Deposit. FORM CF-941 - EMPLOYER’S QUARTERLY RETURN Every employer must file a Form CF-941, Employer’s Quarterly Return of Income Tax Withheld, for each calendar quarter. Form CF-941 must be filed even if no tax was withheld during a quarter or when all tax withheld was previously paid on Forms CF-501 for the quarter. The amount to remit with Form CF-941 is the amount tax withheld for the quarter not previously deposited for the first or second month of the quarter. MAILING ADDRESSES FOR MAILING WITHHOLDING TAX RETURNS Refer to Appendix G for a listing of each city’s mailing address. All checks, money orders, etc. in payment of withholding taxes should be made payable to City of (name of city). All payments must be submitted with a monthly or quarterly withholding tax form. DUE DATES Each withholding deposit is due on the last day of the month following the month in which the tax withheld exceeds $100. Each quarterly return is due on the last day of the month following the end of the quarter. Example: CF-501 Monthly Deposit for January is due February 28 (or 29 if a leap year). CF-501 Monthly Deposit for February is due March 31. CF-941 Quarterly Return for 1st calendar quarter is due April 30. When the due date of a deposit or return falls on a Saturday, Sunday or holiday the due date is automatically extended to the next business day.



CORRECTION OF ERRORS OVER OR UNDER REPORTING TAX WITHHELD Employer Errors Employer’s errors over or under withholding of tax or reporting tax withheld should be corrected as follows:

1) If an error is discovered in the same quarter in which it was made, the employer shall make the necessary adjustment in a subsequent withholding payment within the quarter. (Report the corrected amount of tax withheld on the quarterly return.)

2) If an error is discovered in a subsequent quarter of the same calendar year, the employer shall make the necessary adjustment in a subsequent withholding payment and include it as an adjustment on the next quarterly return. (Report the corrected amount of tax withheld on the quarterly return.)

3) If an error is discovered after the end of the year but before W-2 forms are issued to employees, the employer shall make the necessary adjustment when filing Form CF-W-3 and: a) Pay any additional withholding tax due with Form CF-W-3; or b) Report the overpayment of tax withheld on Form CF-W-3 by reporting that the withholding

tax paid is greater than the total tax withheld as reported on the enclosed Forms W-2, and include a separate written request for refund of the overpayment with a specific explanation of the error(s) causing the overpayment of tax withheld. Overpayments of withholding will not be credited toward tax due in a subsequent year.

4) If an error of underreporting tax withheld is discovered in a subsequent year after the issuance of Forms W-2 to employees, the employer shall notify the Income Tax Department of the error by filing an amended CF-W-3, including a copy of the corrected Form(s) W-2C issued to employee(s), and pay any additional withholding tax due with the amended Form CF-W-3.

5) If an error of over reporting tax withheld on a Form W-2 is discovered, the city will not refund the over withheld tax. The employer should seek to recover the over reported tax withheld from their employee.

Employee Errors If an error causing over withholding of tax is due to an employee’s error or any reason other than an employer’s error, the employer shall neither refund the excess tax withheld to the employee nor offset the excess tax withheld by under withholding in a subsequent period. Example: an employee fails to timely provide employer with a Form CF-W-4. The employer is required to withhold tax from wages to the employee at the resident tax rate. The employee subsequently provides a properly completed form CF-W-4. The employer should start withholding at the correct tax rate from the date the Form CF-W-4 is received from the employee. The employer may not go back and correct the over withholding caused by the employees failure to file a timely Form CF-W-4. Another example is an employee claiming fewer exemptions than allowed filing a new Form CFW-4 to increase the number of exemptions. The increase number of exemptions may only affect withholding going forward from the date the new Form CF-W-4 was filed. CORRECTION OF FORM W-2 ERRORS OVER OR UNDERREPORTING INCOME An employer is required to file an amended Form CF-W-3 upon issuance of a Form W-2C to an employee correcting the reporting of: Box 1, wages; Box 11, nonqualified plans; or Box 16, wages. A copy of Form(s) W-2C must be submitted with the amended Form CF-W-3.

ANNUAL REPORTS An Employer’s Annual Reconciliation of Income Tax Withheld, Form CF-W-3, is required to be filed by last day of February of the following year. A W-2 form for each employee subject to the city’s income tax withholding must be included with Form CF-W-3. Form CF-W-3 is included in the annual withholding tax booklet and is also available on each city’s website.



A copy of Form W-2 issued to each employee subject to the city’s income tax must be filed whether the tax was withheld or not. The Form W-2 must provide the following information:

1) The name, address and federal identification number of the employer. 2) The name, home address and social security number of the employee. 3) The total gross wages paid the employee for the year even if the total wages did not have the

tax withheld for the city. 4) The total tax withheld for the city for the year. The amount of tax withheld must be clearly

labeled as being the city’s income tax withheld, and the city must be properly identified in the locality name box on the Wage and Tax Statement, Form W-2. Failure to properly and clearly identify the city for which the tax was withheld in the locality box of Form W-2 makes the form unacceptable. An improperly identified city in the locality name box of Form W-2 does not satisfy the withholding tax reporting requirements of the income tax ordinance of the city, and will not be accepted as the basis for a tax payment or refund when attached to an individual’s income tax return for the city.

Employers wishing to purchase one of the commercially available W-2 forms in order to combine the city, state and federal reporting in one operation are permitted to do so, provided one copy is submitted to the city by the employer. Many cities accept filing of employer’s Forms W-2 via CD-ROM in lieu of paper Forms W-2. Information and specifications for filing via CD-ROM are available on each city’s website.

SALE OR DISCONTINUANCE OF BUSINESS An employer who sells or discontinues business must file a Notice of Change or Discontinuance. This form is included in the annual withholding tax forms booklet and also available on each city’s website. An employer who goes out of business or permanently ceases to be an employer must file Forms W-2 and a CF-W-3 by the date the final withholding payment is due.

FORMS, INSTRUCTIONS AND INFORMATION Income tax forms, instructions and additional information are available on each city’s website. Withholding Tax Tables are available as a separate document on each city’s website. Each city provides withholding tax assistance on their website and via telephone. Copies of the Ordinance and the Rules and Regulations adopted by each city are usually available from the City Clerk’s office. Usually a city’s income tax ordinance is available from each city’s website under the City Clerk’s menu item Municipal Code, search for “income tax” to get to the ordinance. The Michigan Uniform City Income Tax Ordinance (MCL 141.601 et seq.) is available on the Michigan Legislature website at http://www.legislature.mi.gov. Search for “city income tax” under the Michigan Compiled Laws Search, MCL Content, next click on “Act 284 of 1964” (it should be the top item) and then click on Document “284-1964-2” to get to the Michigan Uniform City Income Tax Ordinance. Note that Document “284-1964-3” contains the alternative sections of the ordinance.

DISCLAIMER NOTICE These instructions are interpretations of the Michigan Uniform City Income Tax Ordinance as adopted by each city. The city’s ordinance will prevail in any disagreement between the tax forms, instructions, information, etc. and each city’s ordinance.



ADDRESS SERVICE REQUESTED

2016 CITY OF {CITY NAME} 2016 EMPLOYER'S WITHHOLDING TAX

FORMS AND INSTRUCTIONS

ONLINE FILING AND PAYMENT OF WITHHOLDING TAX

SOME CITIES ALLOW ONLINE FILING OF EMPLOYER WITHHOLDING TAX WITH ELECTRONIC DIRECT DEBIT PAYMENT OF TAX DUE. SEE APPENDIX F FOR A LISTING OF THESE CITIES AND, GO TO THEIR WEBSITE FOR INSTRUCTIONS.

WHO IS REQUIRED TO WITHHOLD? Every employer who: 1. Has a location in the city; or 2. Is doing business in the city.

WITHHOLD AT THE FOLLOWING TAX RATE: 1. For a resident of the city withhold at the resident tax rate for an employee who: a. Works in the city; or b. Works outside the city but is not subject to withholding for the city where they work.

2. For a resident of the city working another city levying a city income tax: a. Calculate the amount to withhold at the resident tax rate on all wages paid to the employee; b. Calculate the amount of tax to withhold on the employee’s wages subject to withholding by the

other city; c. Subtract the lesser of the actual tax withheld from the employee in step b or one-half of the tax

calculated in step a from the amount of withholding calculated in step a. d. The amount calculated in step c is the amount to withhold for the employee’s city of residence.

3. For a nonresident of the city withhold at the nonresident tax rate on wages paid to the employee

for work performed in the city.

2016 W-2 FORMS WILL BE ACCEPTED VIA ELECTRONIC MEDIA (CD-ROM). FOR SPECIFICATIONS AND INFORMATION REGARDING ELECTRONIC MEDIA FILING, SEE APPENDIX K FOR A LISTING OF THESE CITIES AND, GO TO THEIR WEBSITE FOR INSTRUCTIONS.

QUESTIONS?CALL

{City’s TX. No. per Appendix H} OR VISIT

{City’s website per Appendix H}

MAIL TO:

RETURN TO: {CITY NAME} INCOME TAX} {City Address per Appendix G}



City of {City Name} Income Tax Department

2016 INCOME TAX WITHHOLDING FORMS AND INSTRUCTIONS

THIS BOOKLET CONTAINS THE FOLLOWING FORMS AND INSTRUCTIONS:

A. Notice of Change or Discontinuance (Form CF-6-IT). B. Employer’s Monthly Deposit of Income Tax Withheld, Form CF-501 (used for making monthly

deposit of tax withheld for the first or second month of a quarter). C. Employer’s Quarterly Return of Income Tax Withheld, Form CF-941 (used to report income tax

withheld during the quarter not previously deposited for the first or second month of the quarter). D. Employers Annual Reconciliation of Income Tax Withheld, Form CFW-3. The reconciliation must

be filed on or before the last day of February of the subsequent tax year. E. Instructions for Form CF-501, Employer’s Monthly Deposit of Income Tax Withheld, and Form

CF-941, Employer’s Quarterly Return of Income Tax Withheld. F. Penalty and Interest Worksheet. Most cities require monthly deposit for the first and/or second month of a quarter when the total amount of tax withheld for the city during the month exceeds $100.00 and quarterly deposit of all tax withheld during the quarter not deposited during the first or second month of the quarter. Some cities require only quarterly deposit of tax withheld. See Appendix C for a listing of the deposit requirements for each Michigan city levying an income tax.

IF TAX WITHHELD DURING A MONTH EXCEEDS $100 MONTHLY DEPOSITS, FORM CF-501, ARE DUE AS FOLLOWS:

MONTH DUE DATE MONTH DUE DATE

JANUARY 02/28/2016 JULY 08/31/2016FEBRUARY 03/31/2016 AUGUST 09/30/2016

APRIL 05/31/2016 OCTOBER 11/30/2016MAY 06/30/2016 NOVEMBER 12/31/2016

QUARTERLY RETURNS, FORM CF-941, ARE DUE AS FOLLOWS:

QUARTER DUE DATE QUARTER DUE DATE

FIRST 04/30/2016 THIRD 10/31/2016SECOND 07/31/2016 FOURTH 01/31/2017

When the due date of a deposit or return falls on Saturday, Sunday or holiday the due date is automatically extended to the next business day. PREPARING W-2 FORMS – IF FORM W-2, BOX 20 IS LEFT BLANK OR DOES NOT CLEARLY IDENTIFY THE LOCALITY NAME, YOUR EMPLOYEE WILL EXPERIENCE A DELAY IN THE PROCESSING OF THEIR RETURN. SEE APPENDIX D FOR A LISTING OF CITY NAME ABREVIATIONS FOR ENTRY IN BOX 20.



{City Name} CF-6-IT

Income Tax Department Rev. 11/16/2014

NOTICE OF CHANGE OR DISCONTINUANCE

ACCOUNT NUMBER (FEIN)

CHANGES EFFECTIVE ON (Date)

CURRENT LEGAL NAME

CHANGE LEGAL NAME TO:

DBA

CHANGE DBA TO:

CURRENT LEGAL BUSINESS ADDRESS

CHANGE LEGAL BUSINESS ADDRESS TO:

MAILING ADDRESS

CHANGE MAILING ADDRESS TO:

Instructions: Place an “X” in all boxes that apply. Complete all information for the change. Write any comments or explanations on back of form.

1. The Internal Revenue Service assigned us Federal Employer Identification Number:

2. Our Federal Employer Identification Number is wrong. The correct number is:

3. We have incorporated. Our corporate name is:

4. Our new corporate Federal Employer Identification Number is:

5. Discontinue our withholding tax registration:

a. We no longer have any business activity in the City of {City Name}.

b. We closed our business on:

c. We sold our entire business on:

e. We sold our business to:

d. We sold part of our business on:

Their FEIN is:

6. Address and phone number where we may be reached following discontinuance of business:

Contact person Street address City State Zip Code Phone no.

7. Change in ownership. (Please explain on back)

8. Effective , we changed our fiscal year ending from to Month/Year Month Month 9. Other changes. (Please explain on back SIGNATURE OF PREPARER PRINTED NAME OF PREPARER DATE PREPARED PREPARER’S PHONE NUMBER

( ) MAIL THIS NOTICE AND ANY CORRESPONDENCE TO: {Address per Appendix G}



CF-501 {CITY NAME} INCOME TAX DEPARTMENT 941 01MEMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

DO NOT WRITE 1. IDENTIFICATION NUMBER 2. DEPOSIT PERIOD 3. DUE ON OR BEFORE 4. WITHHOLDING TAX DEPOSIT

IN SPACE BELOW «acct » JAN 2016 02/28/2016TAXPAYER

MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE FIRST MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

PAY TO: CITY OF {CITY NAME}

MAIL TO: {Address per Appendix G}

SIGNATURE DATE

PRINTED NAME OF SIGNER TITLE

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694101M



IN SPACE BELOW «acct » FEB 2016 03/31/2016TAXPAYER

MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE SECOND MONTH OF QUARTER EXCEEDS $100




SIGNATURE DATE



CF-941 {CITY NAME} INCOME TAX DEPARTMENT 941 01QEMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD


IN SPACE BELOW «acct » 1ST QTR 2016 04/30/2016TAXPAYER QUARTERLY DEPOSIT REQUIRED

FOR BALANCE OF TAX WITHHELD DURING QUARTER THAT WAS NOT DEPOSITED FOR FIRST OR SECOND MONTH OF QUARTER




SIGNATURE DATE


{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694101Q





IN SPACE BELOW «acct » APR 2016 05/31/2016TAXPAYER





SIGNATURE DATE





IN SPACE BELOW «acct » MAY 2016 06/30/2016TAXPAYER




MAIL TO: {Address per Appendix G} SIGNATURE DATE





IN SPACE BELOW «acct » 2ND QTR 2016 07/31/2016TAXPAYER QUARTERLY DEPOSIT REQUIRED





SIGNATURE DATE







IN SPACE BELOW «acct » JUL 2016 08/31/2016TAXPAYER





SIGNATURE DATE





IN SPACE BELOW «acct » AUG 2016 09/30/2016TAXPAYER





SIGNATURE DATE





IN SPACE BELOW «acct » 3RD QTR 2016 10/31/2016TAXPAYER

QUARTERLY DEPOSIT REQUIRED FOR BALANCE OF TAX WITHHELD DURING QUARTER THAT WAS NOT DEPOSITED FOR FIRST OR SECOND MONTH OF QUARTER

«name» «address» «city_state_zip»









IN SPACE BELOW «acct » OCT 2016 11/30/2016TAXPAYER





SIGNATURE DATE





IN SPACE BELOW «acct » NOV 2016 12/31/2016TAXPAYER





SIGNATURE DATE





IN SPACE BELOW «acct » 4TH QTR 2016 01/31/2017TAXPAYER QUARTERLY DEPOSIT REQUIRED









City of {City Name} Income Tax Department

INSTRUCTIONS FOR

FORM CF-501, EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD, AND FORM CF-941, EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD

A. MONTHLY DEPOSITS AND QUARTERLY RETURNS 1. Most Michigan cities levying an income tax require monthly deposit of income tax withheld for the first or

second month of a quarter in which the amount withheld exceeds $100.00. Monthly deposits are made using Form CF-501. Remittance in full payable to the {City Name} is required. Monthly deposits are due on the last day of the month following the month. Example: The monthly deposit, Form CF-501, for May is due June 30.

2. Quarterly returns of income tax withheld are filed using Form CF-941. Remittance payable to {City Name} is required. Quarterly returns and payments are due on the last day of the month following the end of the quarter. The quarterly return, Form CF-941, for the first quarter is due April 30.

3. Mail monthly deposits, Form CF-501, and quarterly returns, Form CF-941, to the {Address for city listed in Appendix G}.

4. A monthly deposit is not required if less than $100 is withheld during a month. 5. A quarterly return, Form CF-941, is required even though no tax was withheld during a quarter. Under such

circumstances, a quarterly return, form CF-941, must be filed showing zero tax withheld. 6. If the payment of wages has been temporarily discontinued for any reason, such as the seasonal nature of the

business, the employer must continue to file returns. 7. If you would like to get information on how to file your payments by ACH debit or credit please call

{phone number listed in Appendix H for city}. B. INITIAL RETURNS

1. Registration forms can be found on the city’s website, {city’s website address per Appendix H}. 2. If you cannot wait for forms to timely file your first return, include a letter with your withholding tax payment

providing the following information: Name of Business Owner(s), Type of Ownership, Federal Employer Identification Number (FEIN), d.b.a., physical address, mailing address and period covered.

3. If you have applied for, but not yet received, an FEIN, write "FEIN Pending" in place of the FEIN. A temporary number will be assigned. Notify the Income Tax Department as soon as you receive your FEIN.

4. If a business is sold or transferred at any point during a reporting period, both the old and new employer must file returns for the period. Neither employer should report tax withheld by the other; both employers should use their own FEIN numbers. Also see instructions for Final Returns.

C. FINAL RETURNS – NOTICE OF CHANGE OR DISCONTINUANCE 1. If no wages are to be paid in the future, complete and file a Notice of Change or Discontinuance, Form CF-IT-6. 2. If the business has been sold or transferred, provide the name of the new owner(s), the date transferred and their

FEIN. Also, provide the name, address and telephone number of the person who will have custody of the books and records of the discontinued business.

3. When discontinuing a business, the Employer's Annual Reconciliation of Income Tax Withheld, Form CFW-3, and a W-2 form for each employee must be filed. These forms are due by the end of the month following the end of the quarter of discontinuance.

D. ALL EMPLOYERS 1. Pre-printed forms should be used in filing returns. Forms can be obtained at {city’s website address per

Appendix H}. 2. Verify the name, address and FEIN on the monthly deposit and quarterly return forms (CF-501 and CF-941). If

an error is noted, the necessary corrections should be made on the form, and a Notice of Change or Discontinuance should be completed and filed.

3. DO NOT TAKE CREDIT FOR A PRIOR YEAR'S WITHHOLDING OVERPAYMENT! A claim for refund of any prior year's overpayment must be submitted. See Form CFW-3 for instructions for filing a refund claim.

4. Calculate and remit penalty and interest on all delinquent tax payments and delinquent returns. A sample Penalty and Interest Worksheet, including penalty and interest rates and instructions, is reproduced on the back cover of this booklet. Attach a copy of the penalty and interest worksheet to all delinquent returns and remit the penalty and interest with the tax withheld.



2016 CF-W-3 CF-W-3 2016

1. Employer's, IRC Sec. 3504 agent's or CPEO's name 6. Federal employer identification number

2. Address (number, street and room or suite number) 7. Due on or before

February 28, 2017 3. City, state and zip code 4. State 5. Zip code

Revised 11/20/2015

8a. If line 1 is a Sec. 3504 agent or a CPEO, enter client employer's name 8b.FEIN of employer listed on line 8a

01M January 02M February01Q March/First Quarter

FIRST QUARTER TOTAL04M April05M May02Q June/Second Quarter

SECOND QUARTER TOTAL 07M July08M August03Q September/Third Quarter

THIRD QUARTER TOTAL10M October11M November04Q December/Fourth Quarter

FOURTH QUARTER TOTAL

9. TOTAL WITHHOLDING TAX PAID (Sum of withholding tax X payments reported in column above) 9.10. NUMBER OF FORMS W-2 ATTACHED 10.11. TOTAL TAX WITHHELD PER FORMS W-2 11.12. BALANCE DUE (Line 9 less line 11) 12.13. OVERPAYMENT (Line 11 less line 9) *ATTACH EXPLANATION 13.

Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete.14. SIGNATURE 15. NAME AND TITLE (PLEASE PRINT) 16. DATE 17. PHONE NUMBER

Enclose the required copies of Forms W-2 and, if necessary, payment of any balance due and/or Form CF-W-3S with Form CF-W-3

Mail to {City Name} Income Tax Department{Address for city listed in Appendix G}

EMPLOYER'S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

SUMMARY OF TAX WITHHELD AND WITHHOLDING TAX PAID

Attach Forms W-2 (elctronic format or paper copy) and payment of any balance due (line 12.)

CITY OF {CITY NAME}

WITHHOLDING TAX PAIDTAX WITHHELDMONTH/QUARTER

* Submit a letter to request a refund. Include a detailed explanation on the cause of the overpayment. Refunds will not be issued without an explanation.



2016 CF-W-3S CF-W-3S 2016

1. Employer's, IRC Sec. 3504 agent's or CPEO's name 6. Federal employer identification number

Revised 10/15/2015

9. TOTAL WITHHOLDING TAX PAID (Add totals from all columns; enter here and enter X on Form CF-W-3, line 9) 9.

SUMMARY OF FORMS W-2 SUBMITTED

10. TOTAL NUMBER OF FORMS W-2 X (Total lines in column; enter here and on XX Form CF-W-3, line 10) 10.

11. TOTAL TAX WITHHELD PER W-2sXX (Total lines in column; enter here and on Form CF-W-3, line 11) 11.

If the tax withheld as reported on Forms W-2, box 19, was reported under more than one FEIN (Form W-2, box b) enter the FEIN, the number of Forms W-2, the total tax withheld on the forms and the Locality name (Form W-2, box 20) on separate lines for each FEIN

NUMBER OF FORMS W-2 SUBMITTED

TOTAL TAX WITHHELD

(Form W-2, box 19)

LOCALITY NAME ON FORMS W-2

(Form W-2, box 20)

TOTALS (Enter total of each separate column)

NOV (011M)DEC (04Q)

SEP (03Q)OCT (010M)

JUL (07M)AUG (08M)

MAY (05M)JUN (02Q)

MAR (01Q)APR (04M)

JAN (01M)FEB (02M)

EMPLOYER FEIN (Form W-2, box b)

CITY OF {CITY NAME}SUPPLEMENT TO EMPLOYER'S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

SUMMARY OF WITHHOLDING TAX PAID

If withholding tax payments for the year were made under one or more FEINs, enter the FEIN and the payments made under each FEIN in a separate column

FEIN UNDER WHICH PAYMENTS WERE SUBMITTED ▼ 3rd FEIN ▼ ▼ 4th FEIN ▼▼ 1st FEIN ▼ ▼ 2nd FEIN ▼

MONTH OR QUARTER OF

PAYMENT

WITHHOLDING TAX PAID






{CITY NAME} INSTRUCTIONS FOR

FORM CF-W-3, EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD AND FORM CF-W-3S, SUPPLEMENT TO EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

Revised 10/15/2015

Page 1 of 2

GENERAL INSTRUCTIONS Employers withholding city income tax are required to annually reconcile the city income tax withheld to the city income tax withholding paid. Form CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld, is the form used to make this reconciliation. A copy of each Form W-2 issued by the employer is required to be filed with Form CF-W-3. Electronic filing of Forms W-2 via CD-ROM or DVD is allowed by some cities. Refer to the city’s website for information about acceptance of electronic filing of Forms W-2 and the Form W-2 file formats accepted by the city. Forms W-2 cannot be submitted in PDF format.

IRC Sec. 3405 Agent An employer’s withholding agent under Internal Revenue Code (IRC) Sec. 3405 must also become the employer’s withholding agent for the city. This is accomplished by the Employer and the IRC Sec. 3405 withholding agent filing Form CF-2678, Employer/Payor Appointment of Agent with the city. This type of withholding agent files city income tax Form CF-W-3 and the associated Forms W-2 under the withholding agent’s federal employer identification number (FEIN). When filing Form CF-W-3 with the city, the reporting agent shall report the employer’s name and FEIN on Form CF-W-3. A non-certified professional employer organization (PEO) may be an IRC Sec. 3405 reporting agent.

Certified Professional Employer Organization (CPEO) Starting in year 2016, a PEO may be certified under IRC Sec. 3511(a)(1). A CPEO becomes the co-employer of record responsible for city income tax withholding and must register with the city by filing Form CF-SS-4, Employer’s Withholding Registration. The CPEO must file Form CF-W-3 and associated Forms W-2 under their FEIN. When filing Form CF-W-3 with the city, the CPEO shall report the employer’s name and FEIN on Form CF-W-3.

Common Paymaster A common paymaster must file Form CF-W-3 and associated Forms W-2 under the same FEIN as the one used on the federal Forms W-3 and W-2.

Filing Form CF-W-3 Withholding Payments Made Under More Than One FEIN. When withholding tax paid was reported to the city under more than one FEIN, Form CF-W-3S, Employer’s Annual Reconciliation of Income Tax Withheld, must be filed with Form CF-W-3. Form CF-W-3S, Summary of Withholding Tax Paid section identifies all FEIN’s under which withholding tax payments were made and the month or quarter of each payment. The form totals the withholding tax payments made under each FEIN and

the totals all of the withholding tax payments made on line 9, The total of all withholding tax payments are also entered on Form CF-W-3, line 9.

Tax Withheld on Forms W-2, Box 19, Reported under More Than One FEIN (Form W-2, box b) When the Forms W-2 filed with Form CF-W-3 report more than one employer FEIN in Form W-2, box b, Form CF-W-3S must be filed with Form CF-W-3. Form CF-W-3S identifies all FEINs under which Forms W-2 were filed, the number of Forms W-2 filed under each FEIN and the locality name reported, Forms W-2, box 20.

SPECIFIC INSTRUCTIONS FOR FORM CF-W-3 Line 1. Enter the name of the employer, IRC Sec. 3504 agent or CPEO.

Line 2. Enter the street address including suite or room number of the person named on line 1.

Lines 3, 4 and 5. Enter the city, state and zip code under the respective line number.

Line 6. Enter FEIN of the person named on line 1.

Line 7. Enter the due date if not already preprinted.

Line 8. If the entry on line 1 is an IRS Sec. 3504 agent or a CPEO, enter the employer’s or co-employer’s FEIN

Summary of withholding tax paid section. Under this section report the actual tax withheld each month and the withholding tax deposits and payment made each month or quarter. If withholding tax payments were made under FEIN’s in addition to the one reported on line 6, write across this section “SEE FORM CF-W-3S and complete the Summary of Withholding Tax Paid section of Form CF-W-3S.

Line 9. Enter the total withholding tax paid from the lines above or if withholding tax was paid under more than one number, the total from form CF-W-3S, line 9.

Line 10. Enter the number of Forms W-2 attached to this form or if Forms W-2 were filed under more than one FEIN, enter the total from Form CF-W-3S, line 11.

Line 11. Enter the total tax withheld as reported on the attached Forms W-2 or if Forms W-2 were filed under FEINs other than the one reported on line 6, enter the total from Form CF-W-3S, line 11.

Forms W-2 must be submitted with Form CF-W-3. The preferred format is the federal EFW2 format. The city tax proprietary (CTP) format may also be used. Electronic format Form W-2 data must be submitted on CD-ROM or DVD. See Appendix K for specifications. Forms W-2 cannot be submitted in PDF format. Paper copies of the actual Forms W-2 are acceptable. A listing, summary or printout of Form W-2 data will not be accepted.



{CITY NAME} INSTRUCTIONS FOR

FORM CF-W-3, EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD AND FORM CF-W-3S, SUPPLEMENT TO EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

Revised 10/15/2015

Page 2 of 2

Submit only Forms W-2 for employees subject to the specific city’s income tax and Forms W-2 reporting city tax withheld for the specific city. Form W-2, box 20, data should only be an authorized locality name abbreviation. See Appendix D for a listing of authorized locality name abbreviations.

Line 12. Enter the balance due, line 9 less line 11. If no balance due enter a zero (0). The balance due must be paid full with Form CF-W-3.

Line 13. Enter any overpayment, line11 less line 9. If no overpayment, enter a zero (0). A refund of any overpayment will not be made unless a letter explaining the overpayment and requesting the refund is submitted with Form CF-W-3.

Line 14. Have the individual responsible for preparing Form CF-W-3 sign the return on line 14.

Line 15. Type or print the name and title of the individual signing the return on line 14.

Line 16. Enter the date the reconciliation was signed.

Line 17. Enter the phone number of the individual signing the return.

After Form CF-W-3 is completed, please double check the entries on lines 1 through 6. Also, if Form CF-W-3 is submitted by a Sec 3504 agent or a CPEO, check the employer’s name and FEIN reported for the employer on lines 8a and 8b.

Filing Form CF-W-3 Mail the completed Form CF-W-3 along with the Forms W-2, payment of any tax due, a letter explaining any overpayment and requesting a refund if necessary and Form CF-W-3S if necessary to: {City Name} Income Tax Department {Address for city as listed in Appendix G}

SPECIFIC INSTRUCTIONS FOR FORM CF-W-3S Line 1. On line one, enter the name as stated on Form CF-W-3 line 1.

Line 6. Enter the FEIN of the person named on line 1.

Summary of Withholding Tax Paid Complete this section only when withholding tax was paid to the city under more than one FEIN. Use a separate column to report withholding tax paid under each FEIN by listing the FEIN of the payor and the payments on the line for the corresponding month or quarter. Enter the total withholding tax paid under each FEIN on the totals line of the column. On line 9 enter the grand total of withholding tax paid under all FEINs. Also enter the total tax withheld on Form CF-W-3, line 9.

Summary of Forms W-2 submitted Complete this section only when Forms W-2, filed with Form CF-W-3, report more than one FEIN in box b. Use a separate line for each FEIN reported on Form W-2, box b. In the related column for each line enter the FEIN, the number of Forms W-2 filed under the FEIN, the total tax withheld under the FEIN and the abbreviation for the locality name of the city for which the tax was withheld. See Appendix D for a listing of the authorized city name abbreviations for entry into Form W-2, box 20, for each of the 22 Michigan cities levying a city income tax.

Line 10. Total the number of forms W-2 listed in this column and enter the total on line 10. Also enter this total on Form CF-W-3, line 10.

Line 11. Total the amount of tax withheld listed in this column and enter the total on line 11. Also enter this total on Form CF-W-3, line 11.

Complete the reconciliation process by completing Form CF-W-3, lines 12 through 17. Submit this Form CF-W-3 along with Form CF-W-3 and the related forms W-2. DISCLAIMER NOTICE These instructions are interpretations of the Uniform City Income Tax Ordinance, MCLA 141.601 et seq. The specific city’s ordinance will prevail in any disagreement between these instructions and the ordinance.



CITY OF {CITY NAME} INCOME TAX DEPARTMENT

PENALTY AND INTEREST WORKSHEET

FOR DELINQUENT WITHHOLDING TAX RETURNS

RETURN PERIOD DUE DATE TAX DUE INTEREST PENALTY MINIMUM P & I TOTAL DUE

Attach a copy of completed worksheet to each delinquent return. INTEREST CALCULATION INSTRUCTIONS: Interest is due from the due date of a return until the tax is paid. Interest Rates: For period 1/1/2012 through 12/31/2012 the interest rate is 4.25% per year or 0.0001161 per day. For period 1/1/2013 through 12/31/2013 the interest rate is 4.25% per year or 0.0001164 per day. For period 1/1/2014 through 12/30/2014 the interest rate is 4.25% per year or 0.0001164 per day. For period 1/1/2015 through 12/31/2015 the interest rate is 4.25% per year or 0.0001164 per day. For period 1/1/2016 through 12/31/2016 use the interest rate listed for 2015 or the city for rate. Interest rates are set by the Michigan Department of Treasury. The interest rate changes every six months. Interest

rates for current or past periods are found on the Michigan Department of Treasury web site, http://www.michigan.gov/treasury under Revenue Administrative Bulletins. Look for the most recent interest rate bulletin.

Interest Computation: For Interest Rate Period: 1/1/2012 to 12/31/2012: Number of days after due date: _____ times 0.0001161 times tax due = $_________ 1/1/2013 to 12/31/2013: Number of days after due date: _____ times 0.0001164 times tax due = $_________ 1/1/2014 to 12/31/2014: Number of days after due date: _____ times 0.0001164 times tax due = $_________ 1/1/2015 to 12/31/2015: Number of days after due date: _____ times 0.0001164 times tax due = $_________ 1/1/2016 to 12/31/2016: Number of days after due date: _____ times 0.0001164 times tax due = $_________ Total interest. Add the interest calculated on the lines above and Enter on the INTEREST line of the worksheet. Total Interest $_________ PENALTY CALCULATION INSTRUCTIONS: Penalty is due upon failure to timely file a return or failure to timely pay tax due. Penalty Rate: One percent (1%) of the tax due per month (or portion thereof) per return. A penalty of one percent of the tax due is applied on the first day after the due date of the return. An additional penalty of one percent of the tax due is added on the first day of each subsequent month. Maximum penalty is 25% of the tax due per return. Penalty Computation: Number of months delinquent times 1% (.01) times the tax due = $_________ Enter the penalty calculated on the PENALTY line of the worksheet. MINIMUM PENALTY AND INTEREST CALCULATION: The minimum amount of penalty and interest combined is $2.00 per return. Calculation of minimum penalty and interest: If total penalty and interest is greater than $2.00 minimum does not apply. If total penalty and interest is less than $2.00, enter $2.00 on the MINIMUM P & I line of the worksheet.



Part I. Identification and addresses of employer or certified professional employer organization 1. Employer application 2. Certified professional employer organization (CPEO) co-employer application

3. Complete company name (include, if applicable, Corp., Inc., LLC, etc.) 4. Federal Employer Identification Number

5. Business name, assumed name or DBA (if used) 6. Business phone number

7. Enter street number and name (include apartment or suite number after street name)

8. Enter Address Line 2:

9. City 10. State 11. Zip Code







Part II. General information 1. Date first wages subject to city withholding paid 1a. 7. Reinstated old business; enter old FEIN7a. 2. Number of employees subject to city withholding 2a. 8. Started "doing business" in city; enter date 8a. 3. Reasons for filing withholding registration 9. CPEO with new client in the city. Enter client's FEIN on line 11a and

4. Started a new business; enter date 4a. complete items 11 and 12 below 9a. 5. Incorporated an existing busines 10. Other (explain) 10a. 6. Purchased a going business (complete items 11 and 12 below)

11. Name of previous owner or PEO's client 12. Will the previous owner or PEO's client continue to 12a. Yesx have employees subject to city income tax withholding 12b. No

13. Does your tax year end in December 31 13a. Yes 13b. No If no, provide the fiscal year end month and day 13c.

Part. III. Income tax withholding - Filing and payment of income tax withheld Check box below to indicate how withholding tax returns are prepared and filed

1. Our withholding tax returns are prepared in house, filed and paid 5. An IRC Section 3504 agent is authorized to prepare, file and pay X and all returns and Forms W-2 are filed and paid under our FEIN X our withholding tax returns and Forms W-2; all withholding tax 2. A common paymaster prepares our withholding tax returns: X returns and Forms W-2 are filed under the agents FEIN. Attach aX Withholding tax is paid under FEIN 2a. X copy of federal Form 2678. ATTACH A COMPLETED FORM

X Forms W-2 are filed under FEIN 2b. X CF-2678 AS A PART OF THIS REGISTRATION

3. A payroll services provider prepares our withholding tax returns 6. A professional employer organization is authorized under a PEO X and Forms W-2. Returns and Forms W-2 are filed and paid under X agreement to prepare, file and pay our withholding tax returns X our FEIN X and Forms W-2 under their FEIN. Attach a copy of the PEO 4. A payroll reporting agent is authorized to prepare our withholding X agreement. A certified PEO must be registered with the city as aX tax returns and Forms W-2 which are filed and paid by the agent X co-employer liable for filing and payment of withholding tax X under our FEIN. Attach a copy of Form 8655 filed with the IRS. 7. We are a CPEO preparing, filing and paying or clients cityX ATTACH A COMPLETED FORM CF-8655 AS PART OF THIS X withholding tax under our FEIN. Attach a copy of the IRSX REGISTRATION X certification.

LEGAL ADDRESS

MAILING ADDRESS

PHYSICAL ADDRESS OF PROJECT OR

ACTIVITY IN CITY

Month (MM) Day (DD)

CF-SS-4 City of {City Name} CF-SS-4

PLEASE TYPE OR PRINT

INCOME TAX DEPARTMENT PLEASE TYPE OR PRINTEmployer’s Withholding Registration



Complete company name (include, if applicable, Corp., Inc., LLC, etc.) Federal Employer Identification Number

Part IV. Type of business ownership (Check all boxes that apply) 1. Individual/Sole Proprietorship (Identify owner in 8. Michigan Corporation (Identify all corporation officers in X Part III below) X Part III below) 2. General Partnership 8a. Michigan Subchapter S Corporation X (Identify all partners in Part III below) 8b. Michigan Professional Corporation 3. Limited Partnership (LP) 9. Foreign (Non-Michigan) Corporation (Identify all corporation X (Identify general partners in Part III below) X officers in Part III below) 4. Professional Limited Liability 9a.Foreign Subchapter S Corporation 5. Partnership (LLP) (Identify all 10. Nonprofit Corporation (Identify all corporation officers in X General Partners in Part III below) X Part III below) 6. Limited Liability Company (LLC) 11. Government X (Identify all members in Part III below) 12. Estate (Identify estate administrator or personal 7. Professional Limited Liability Company (PLLC) X representative in Part III below)X (Identify all members in Part III below) 13. Trust (Identify trustee in Part III below)

14. Other (explain)

Part V. Identification of each owner, partner, member or corporate officer (Attach Part VII if more than 2) 1a. Name (last, first middle, suffix) 1g. Home Telephone Number

1b. Business Title 1h. Date of Birth

1c. Residence Address (street number and name including apartment number after street name) 1i. Social Security Number

1d. City 1e. State 1f. Zip Code 1j. Drivers License Number/ ST ID Number

2a. Name (last, first middle, suffix) 2g. Home Telephone Number




Part VI. Contact information 1. Contact person for withholding tax questions 2. E-mail address of contact person

3. Phone number for contact person above. 4a.

Part VII. Signature area Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete. 1a. Signature (owner, member or officer who controls or is responsible for 1b. TitleX filing withholding tax returns and paying the income tax withheld)

1c. Type or print name of person signing above 1d. Date

Mail to: {Address for city as listed in Appendix G} Form CF-SS-4, page 2, revised 11/19/2015

CF-SS-4 Questions about this application? Call the Income Tax Department at {city phone number as in Appendix H}.

Information collected on this form is confidential pursuant to MCL 141.674(1), Michigan Uniform City Income Tax Ordinance; Sec.74(1). Information gained by the administrator, city treasurer or any other city official, agent or employee as a result of a return, investigation, hearing or verification required or authorized by this ordinance is confidential, except for official purposes in connection with the administration of the ordinance and except in accordance with a proper judicial order.



Complete company name (include, if applicable, Corp., Inc., LLC, etc.) Federal Employer Identification Number

Part VII. Identification of each owner, partner, member or corporate officer (Part V Continued) 3a. Name (last, first middle, suffix) 3g. Home Telephone Number
























Form CF-SS-4, page 3, revised 09/29/2015



{CITY NAME} INSTRUCTIONS FOR FORM CF-SS-4

EMPLOYERS WITHHOLDING TAX REGISTRATION

General Instructions Use these instructions to complete Form CF-SS-4, Employers Withholding Registration.

Purpose of Form Form CF-SS-4 is used to register for withholding of income tax from wages paid to employees.

Employer’s required to register and withhold Every employer having a location or “doing business” in the city is required to register and withhold city income tax.

An example is a contractor even though the contractor is physically located outside the city who is working as a subcontractor on a project in the city is “doing business” in the city and is required to withhold city income tax.

Employers not required to withhold city income tax are encouraged to voluntarily register and withhold tax from wages paid to their resident employees.

Certified Professional Employer Organization A certified professional employer organization (CPEO) is required to register: when the PEO is a co-employer under a PEO agreement with a client (co-employer) who is required to register and withhold city income tax; the PEO agreement makes the PEO responsible for filing withholding tax returns and payment of the income tax withheld or required to be withheld; and the PEO is designated as a CPEO by the internal Revenue Service (IRS) under Internal Revenue Code (IRC) Section 3511(a)(1).

Withhold from wages paid to the following employees All wages paid to employees who are residents of the city whether or not they work in the city; All wages paid to employees who are non-residents of the city who work in the city. (Withhold only on wages earned in {City Name}). See the Withholding Tax Guide or the Michigan Uniform City Income Tax Ordinance, Sections 141.651 through 141.665 for more information relative to withholding city income tax.

Specific Instructions Follow the instructions for each line to expedite processing and to avoid unnecessary requests for additional information. Also, be sure to attach copies of IRS forms or certifications when requested by these instructions or the registration form.

Part I. Identification and addresses of employer or certified professional employer organization Line 1. If you are an employer registering to withhold tax; check (X) the box to the left of line 1 otherwise leave the box blank.

Line 2. If you are a CPEO registering to withhold tax; check (X) the box to the left of line 2 otherwise leave the box blank.

Line 3. Enter the complete legal name of the entity (or individual) registering.

Line 4. Enter the FEIN of the entity (or individual) registering.

Line 5. Enter the business name, trade name, assumed name or DBA of the registrant if one is used; otherwise enter N/A.

Line 6. Enter the business phone number of the entity (or individual) registering.

Lines 7 – 21. Enter the address data as requested for each Legal address, mailing address, and the physical, project or activity address located in the city.

Part II. General information Line 1. Enter the first date wages subject to city income were paid.

Line 2. Enter the number of employees currently subject to city’s income tax withholding.

Line 3. Instruction only no entry required.

Lines 4.-10. Check (X) the box to the left of the number indicating the reason for filing this withholding registration. Where a date, FEIN or explanation is requested for a line checked, enter information requested.

Line 11. If the box on line 6 is checked, enter the name of the previous owner of the business and if the box on line 9 is checked enter the name of the CPEO’s client.

Line 12. If one of the boxes on lines 6 or 9 is checked, check (X) box 12a if the previous owner or the CPEO client will continue to have employees subject to city income tax withholding; otherwise check (X) the box on line 12b. If the boxes on line 6 and line 9 are both not checked, leave blank.

Part. III. Income tax withholding - Filing and payment of income tax withheld Lines 1 – 6. If this is an employer’s registration, check (X) the appropriate box to indicate how your



withholding tax returns are prepared and filed. An employer is liable for the filing, deposit and payment of withholding tax regardless of the type agent filing, depositing and paying the withholding tax except, after 1/1/2016, when an employer uses a CPEO who is registered to withhold the city’s income tax.

A CPEO registering to withhold must check the box on line 7 of this part of the registration form.

Part IV. Type of Business Ownership Check the box to the left of the line number to indicate the type of ownership of the person registering. If the box on line 8 is checked also check the box on line 8a if a Michigan Subchapter S corporation, or check the box on line 8b if a Michigan professional corporation. If the box on line 9 is checked, also check the box on line 9a if the foreign (not a Michigan) corporation is a foreign Subchapter S corporation.

Part V. Identification of each owner, partner, member or corporate officer Lines 1a – 2j. Enter the requested information for each owner, partner, member or corporate officer of the business, including CPEOs. If there are more than two owners, partners, members or corporate officers, enter the data for the additional individuals in Part VII, a continuation of Part V.

Part VI. Contact Information Lines 1 – 3a. Enter the contact person’s name on line 1, e-mail address on line 2 and phone number on line 3a. This information is important and must be updated when the contact person changes.

Part VII. Signature area Line 1a. The registration must be signed by (a) the individual, if the applicant is an individual; (b) principal officer responsible for income tax withholding, if the applicant is a corporation; (c) the responsible and duly authorized member or officer responsible for income tax withholding, if the applicant is a partnership, LLC, government entity, or other unincorporated organization; or (d) the fiduciary, if the applicant is a trust or an estate.

Line 1b. Print or type the title of the person signing the registration on line 1b.

Line 1c. Print or type the name of the person signing the registration on line 1c.

Line 1d. Enter the date the registration was signed on line 1d.

Related Forms Withholding Tax Guide Form CF-SS-4, Employer’s Withholding

Registration

Form CF-2678, Employer/Payor Appointment of Agent

Form CF-8655, Reporting Agent Authorization Employer’s Withholding Tax Forms and

Instructions Booklet General Instructions Listing of Withholding Tax Forms in Booklet

and Due Dates for Monthly (Form CF-501) Deposits and Quarterly (Form CF-941) Returns

Form CF-6-IT, Notice of Change or Discontinuance

Forms CF-501 and Form CF-941, First Quarter Withholding Tax Forms

Forms CF-501 and Form CF-941, Second Quarter Withholding Tax Forms

Forms CF-501 and Form CF-941, Third Quarter Withholding Tax Forms

Forms CF-501 and Form CF-941, Fourth Quarter Withholding Tax Forms

Form CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld

Instructions for forms CF-501, Employer’s Monthly Deposit of Income Tax Withheld and Form CF-941, Employer’s Quarterly Deposit of Income Tax Withheld

Penalty and Interest Worksheet CF-W-4, Employee’s Withholding Certificate CF-2848, Power of Attorney Authorization

Disclosure of information Information collected on Form CF-SS-4 is confidential pursuant to MCL 141.674(1), Michigan Uniform City Income Tax Ordinance; Sec.74(1). Information gained by the administrator, city treasurer or any other city official, agent or employee as a result of a return, investigation, hearing or verification required or authorized by this ordinance is confidential, except for official purposes in connection with the administration of the ordinance and except in accordance with a proper judicial order.

Disclaimer Notice These instructions are interpretations of the Uniform City Income Tax Ordinance, MCLA 141.601 et seq. The specific city’s ordinance will prevail in any disagreement between these instructions and the ordinance.

Revised 11/20/2015



Revised 09/28/2015

Use this form if you want to request approval to have an agent file returns and make deposits or payments of withholding taxes or if you want to revoke an existing appointment.

• If you are an employer or payer who wants to request approval, complete Parts I and II and sign Part II. Then give it to the agent. Have the agent complete Part 3 and sign it.

Note. This appointment is not effective until we approve your request. See the instructions for filing Form CF-2678 on page

• If you are an employer, payer, or agent who wants to revoke an existing appointment, complete all three parts. In this case, only one signature is required.

Part I. Why you are filing this form (Check one of the boxes below)

1. You want to appoint an agent for tax reporting, depositing, and paying.

2. You want to revoke an existing appointment.

Part II. Employer or Payer Information: Complete this part if you want to appoint an agent or revoke an appointment 1. Employer's or payor's name 2.Federal employer identification number

3. Trade name (if any)

4. Address (Street number, street name and suite or room number)

5. City 6. State 7. ZIP code

8. Foreign country name 9. Foreign province/county 10. Foreign postal code

Forms for which you want to appoint an agent or revoke an agent's appointment to file,

Form CF-501 (Employer's Monthly Deposit of Income Tax Withheld) 11a. 11b.Form CF-941 (Employers Quarterly Return of Income Tax Withheld) 11c. 11d.Form CFW-3 (Employer's Annual Reconciliation of Income Tax Withheld) 11e. 11 f.Form W-2 (Wage and Tax Statement, city copy (via paper or magnetic media) 11g. 11h.

12. Sign your name here 13. Print your title here

14. Print your name here 15. Date (MM/DD/YYYY) 16. Best daytime phone number

After completing and signing Part I and Part II of this form, give this form to the agent to complete Pat III.

Employer/Payor Appointment of Agent

I am authorizing the income tax department of the above named city to disclose otherwise confidential tax information to the agent relating to the authority granted under this appointment, including disclosures required to process Form CF-2678. The agent may contract with a third party, such as a reporting agent or certified public accountant, to prepare or file the returns covered by this appointment, or to make any required deposits and payments. Such contract may authorize the income tax department of the above named city to disclose confidential tax information of the employer/payer and agent to such third party. If a third party fails to file the returns or make the deposits and payments, the agent and employer/payer remain liable.

Form CF-2678 Form CF-2678City of {City Name}INCOME TAX DEPARTMENT

11. For SOME employees/

payees/payments

For ALL employees/

payees/payments



Employer's or payor's name (form Part II, line 1) FEIN (from Part II, line 2)

Form CF-2678, Page 2Part III. Agent Information: If you will be An agent for an employer or payor, or want to revoke an appointment, complete this part. 1. Agent's name 2.Agent's federal employer identification number

3. Agent's trade name (if any)

4. Agent's address (Street number, street name and suite or room number)


8. Foreign country name 9. Foreign province/county 10. Foreign postal code

11. Sign your name here 12. Print your title here


Under penalties of perjury, I declare that I have examined this form and any attachments, and to the best of my knowledge and belief, it is true, correct, and complete.



INSTRUCTIONS FOR FORM CF-2678 Revised 09/29/2015

Purpose of Form Use Form CF-2678 if you want to: 1. Request approval to have an agent file returns and

make deposits or payments of {City Name} income tax withholding; or

2. Revoke an existing appointment.

How to Complete the Form Part I: Why You Are Filing This Form In Part 1, you will check a box to indicate why you are filing Form CF-2678.

If you are an employer or payer and you want to appoint an agent, check the box that says, “You want to appoint an agent for tax reporting, depositing, and paying.”

If you are an employer, payer, or agent and you want to revoke an existing appointment, check the box that says, “You want to revoke an existing appointment.”

Part II: Employer or Payer Information If you are an employer or payer, enter your name, employer identification number (FEIN), trade name, and address.

If you are an agent revoking an existing appointment, enter the FEIN, name, trade name, and address of the employer or payer for whom you have been authorized to act. The employer's or payer's signature is not required.

On line 11, check the boxes for all forms for which you want to: 1. Request approval to appoint an agent to file on your

behalf, or 2. Revoke an agent's existing appointment.

If you are only appointing an agent for all employees, payees, or payments, check the box under For ALL employees/payees/payments.

If you are only appointing an agent for some employees, payees, or payments, check the box under For SOME employees/payees/payments. Example 1. You are an employer. You appoint an agent to file returns and deposit city income tax withholding related to biweekly wage payments that you paid your employees. However, you make bonus wage payments directly to your employees, not through the agent. You should report the bonus payments on a return filed using your FEIN.

Example 2. You are an employer. You appoint an agent to file returns and city income tax withholding for biweekly wage payments that you paid to your employees. However, you make biweekly wage payments directly to your company's executives. You should report the wage payments to the executives on a return filed using your FEIN.

If you are an employer or payer and you are requesting authorization to appoint an agent, sign and date Form CF-2678 in Part 2. Then give the form to the agent to complete and sign Part 3.

If you are an employer or payer and you want to revoke an existing appointment, sign and date Form CF-2678 in Part 2. Complete Part 3. Then send the form to {City Name} {address as listed in Appendix G for the city}.

Part III: Agent Information If you are an employer or payer and you are requesting authorization to appoint an agent, have the agent complete and sign Part 3.

If you are an employer or payer and you want to revoke an existing appointment, complete Part 3. The agent's signature is not required. Then send the form {City Name} {address as listed in Appendix G for the city}.

If you want to accept an appointment as an agent or you are an agent who wants to revoke an existing appointment, complete Part 3 with your information. Then sign and date the form where indicated. Send the form to {City Name} {address as listed in Appendix G for the city}.

Note. If an agent is a corporate officer, partner, or tax matters partner, the agent must have the authority to execute this appointment of agent.

Filing Form 2678 Send Form CF-2678 to {City Name} {address as listed in Appendix G for the city}. We will send a letter to the employer or payer and to the agent after we have approved the request.

The authorization to act as an agent is effective on the date shown in the letter. Until we approve the request, the agent is not liable for filing any tax returns or making any deposits or payments.

Only one signature is required to revoke an agent's appointment. If an existing appointment is revoked, the city income tax department cannot disclose confidential tax information to anyone other than the employer or payer for periods after the appointment is revoked.

If an agent's appointment is revoked, we will send both the employer or payer and the agent a letter confirming the revocation. The revocation is effective on the date shown in the letter.



Revised 09/28/2015

Taxpayer 1. Name of taxpayer( as distinguished from trade name 2.Federal employer identification number

3. Trade name (if any)

4. Address (Street number, street name and suite or room number) 5.Other identification number


9. Contact person 10. Daytime telephone number 11. Fax number

Reporting Agent12. Name (enter company name or name of business 13.Federal employer identification number

14. Address (Street number, street name and suite or room number)


18. Contact person 19. Daytime telephone number 20. Fax number

Authorization of Reporting Agent to Sign and File Returns (Caution: See Authorization Agreement)21.

CF-941 CFW-3 Forms W-2

Authorization of Reporting Agent to Make Deposits and Payments (Caution: See Authorization Agreement)22.

CF-501 CF-941 CFW-3

Disclosure of information to Reporting Agents23a.

23b. Check here if the reporting agent also wants to receive copies of notices from the city income tax department ....……........................................

Disclosure Authorization24.

year forms beginning

Authorization Agreement

I certify I have the authority to execute this form and authorize disclosure of otherwise confidential information on behalf of the taxpayer.12. Sign your name here 13. Print your title here


I understand that this agreement does not relieve me, as the taxpayer, of the responsibility to ensure that all tax returns are filed and that all deposits and payments are made. If line 21 is completed, the reporting agent named above is authorized to sign and file the return indicated, beginning with the quarter or year indicated. If any starting dates on line 22 are completed, the reporting agent named above is authorized to make deposits and payments beginning with the period indicated. Any authorization granted remains in effect until it is revoked by the taxpayer or reporting agent. I am authorizing the income tax department of the above names city to disclose otherwise confidential tax information to the reporting agent relating to the authority granted on line 21 and/or line 22, including disclosures required to process Form CF-8655. Disclosure authority is effective upon signature of taxpayer and receipt of Form 8655 by the income tax department of the above named city. The authority granted on Form 8655 will not revoke any Power of Attorney (Form CF-2848) in effect.

Sign Here

Form CF-8655 City of {City Name} Form CF-8655INCOME TAX DEPARTMENT

Reporting Agent Authorization

Check here to authorize the reporting agent to receive or request copies of tax information and other communications from the income tax department of the above named city related to the authorization granted on lines 21, 22, and/or line 24 ................................................................

Use the entry lines below to indicate the tax return(s) to be filed by the reporting agent. Enter the beginning year of annual tax returns or beginning quarter of quarterly tax returns. See the instructions for how to enter the quarter and year. Once this authority is granted, it is effective until revoked by the taxpayer or reporting agent.

Use the entry lines below to enter the starting date (the first month and year) of any tax return(s) for which the reporting agent is authorized to make deposits or payments. See the instructions for how to enter the month and year. Once this authority is granted, it is effective until revoked by the taxpayer or reporting agent

The reporting agent is authorized to receive otherwise confidential taxpayer information from the income tax department of the city named above to assist in responding to certain notices relating to the Form W-2 series information returns. This authority is effective for calendar



INSTRUCTIONS FOR FORM CF-8655 Revised 09/29/2015

General Instructions

Purpose of Form Use Form 8655 to authorize a reporting agent to:

1. Sign and file certain returns. 2. Make deposits and payments for certain returns; 3. Receive duplicate copies of tax information, notices, and

other written and/or electronic communication regarding any authority granted; and

4. Provide city income tax department with information to aid in penalty relief determinations related to the authority granted on Form 8655.

Note. An authorization does not relieve the taxpayer of the responsibility or the liability for failing to ensure that all tax returns are filed timely and that all withholding tax deposits and payments are made timely. Employers who enroll to make withholding tax payments using the city’s tax tool can view deposits and payments made on their behalf under their federal employer identification number (FEIN).

Authority Granted Once Form CF-8655 is signed, any authority granted is effective beginning with the period indicated on lines 21 or 22 and continues indefinitely unless revoked by the taxpayer or reporting agent. A new authorization must be submitted to the city for any increase or decrease in the authority of a reporting agent to act for its client. The preceding authorization remains in effect except as modified by the new one. No authorization or authority is granted for periods prior to the period(s) indicated on Form CF-8655.

Where authority is granted for any form, it is also effective for related forms such as the corresponding amended return or payment voucher.

Disclosure authority granted on line 23a is effective on the date Form CF-8655 is signed by the taxpayer. Any authority granted on Form CF-8655 does not revoke and has no effect on any authority granted on Form CF-2848 or any third-party designee checkbox authority.

Where To File Send Form CF-8655 to: {City Name} Income Tax Department {Address for city as listed in Appendix G}

You can fax Form 8655 to: {Fax number for city as listed in Appendix H}

Revoking an Authorization If you have a valid Form CF-8655 on file with the city, the filing of a new Form CF-8655 revokes the authority of the prior reporting agent beginning with the period indicated on the new Form CF-8655. However, the prior reporting agent is still an authorized reporting agent and retains any previously granted disclosure authority for the periods prior to the beginning period of the new reporting agent’s authorization unless specifically revoked.

If the taxpayer wants to revoke an existing authorization, send a copy of the previously executed Form CF-8655 to city at the address listed under Where To File, above. Re-sign the copy of the Form 8655 under the original signature. Write

“REVOKE” across the top of the form. If you do not have a copy of the authorization you want to revoke, send a statement to the city. The statement of revocation must indicate that the authority of the reporting agent is revoked and must be signed by the taxpayer. Also, list the name and address of each reporting agent whose authority is revoked.

Withdrawing from reporting authority. A reporting agent can withdraw from authority by filing a statement with the city on paper. The statement must be signed by the reporting agent and identify the name and address of the taxpayer and authorization(s) from which the reporting agent is withdrawing.

Specific Instructions Line 15 Use the “YYYY” format for annual tax returns. Use the “MM/YYYY” format for quarterly tax returns, where “MM” is the ending month of the quarter the named reporting agent is authorized to sign and file tax returns for the taxpayer. For example, enter “09/2015” on the line for “CF-941” to indicate you are authorizing the named reporting agent to sign and file Form CF-941 for the July–September quarter of 2015 and subsequent quarters.

Line 16 Use the “MM/YYYY” format to enter the starting date, where “MM” is the first month the named reporting agent is authorized to make deposits or payments for the taxpayer. For example, enter “08/2015” on the line for “CF-501” to indicate you are authorizing the named reporting agent to make deposits or payments for Form CF-501 starting in August 2015 and all subsequent months.

Who Must Sign Sole proprietorship. The individual owning the business.

Corporation (including a limited liability company (LLC) treated as a corporation). Generally, Form CF-8655 can be signed by: (a) an officer having legal authority to bind the corporation, (b) any person designated by the board of directors or other governing body, (c) any officer or employee on written request by any principal officer, and (d) any other person authorized to access information under section 6103(e) of the Internal Revenue Code..

Partnership (including an LLC treated as a partnership) or an unincorporated organization. Generally, Form CF-8655 can be signed by any person who was a member of the partnership during any part of the tax period covered by Form CF-8655.

Single member LLC treated as a disregarded entity. The owner of the LLC.

Trust or estate. The fiduciary.



Form CF-W-4 — EMPLOYEE’S WITHHOLDING CERTIFICATE Revised 12/02/2014

FOR MICHIGAN CITIES LEVYING AN INCOME TAX (See list below)

1. Print your full name Social Security No. Office, Plant, Dept. Employee Identification No

2. Address, Number and Street Apartment City, Township or Village where you reside State Postal Code

4. Exemptions for yourself (See cities below) 4

5. Exemptions for spouse (See cities below) 5

6. Exemptions for your dependent children 6

7. Exemptions for your other dependents 7

8. Total number of exemptions claimed 8Exemptions allowed by city for taxpayer and spouse, if married.

I do not expect to work in any city listed

of any listed city

Portland$1,000

Saginaw

Walker$600

Grayling$3,000

4. Taxpayer5. Spouse

4. Taxpayer

5. Spouse



$600

Port Huron$600

5. Spouse


Muskegon Heights$600

Pontiac


4. Taxpayer

$600

Muskegon$600

5. Spouse


$750

Springfield$750

5. Spouse


9. Date 10. SignatureI am not a resident


Lansing$600

Lapeer


4. Taxpayer

$600

5. Spouse

4. Taxpayer

$700

Jackson$600

5. Spouse


$1,000

Ionia


4. Taxpayer

Hudson

Hamtramck$600

Highland Park

$600

Deaf Permanently Disabled

Regular exemption

65 or over at end of year

Resident CityExemptions

Nonresident CityExemptionsYOUR WITHHOLDING EXEMPTIONS

Blind

Albion$600

Battle Creek

81% TO

100%

CHECK THE BOX THAT INDICATES THE APPROXIMATE AMOUNT OF TIME WORKING

FOR EMPLOYER IN THE CHECKED NONRESIDENT CITY

UNDER 25%

25% TO

40%

41% TO

60%

CHECK BOX IF YOU ARE A RESIDENT OF

A LISTED CITY

CHECK BOX IF YOU ARE A

NONRESIDENT AND WORK

FOR EMPLOYER IN A LISTED CITY

61% TO

80%

MICHIGAN CITIES LEVYING AN INCOME TAX AND THE VALUE OF ONE EXEMPTION

EMPLOYEE: File this form with your employer. Otherwise your employer must withhold tax for the cities without any allowance for exemptions.

EMPLOYER: Keep this certificate with your records. If the information submitted by the employee is not believed to be true, correct and complete, the City Income Tax Department must be advised.

Big Rapids

Detroit

Flint

Grand Rapids

$600






4. Taxpayer

$750

$600

$600



CF-2848 CITY OF {CITY NAME} INCOME TAX DEPARTMENT

Issued under Authority of the Uniform City Income Tax Ordinance (MCL 141.601 et seq.) Filing is voluntary.

Revised: 05/01/2013

PART 1: TAXPAYER INFORMATIONTaxpayer's (first name, initial, last name or business name) Taxpayer SSN/FEIN

If joint return spouse's first name, initial, last name Spouse SSN

Current address (number and street) Apt./Ste. no. If a business, enter DBA, trade or assumed name

Address line 2 Telephone number Fax number

City, town or post office State Zip code E-mail address

Foreign country name, province/county, postal code

PART 2: REPRESENTATIVE INFORMATION AND AUTHORIZATION DATESRepresentative's name Contact's name (if applicable) Contact's name (if applicable)

Firm name E-mail address E-mail address

Address (number and street) Apt./Ste. no. Telephone number Telephone number

Address line 2 Fax number Fax number

City, town or post office State Zip code Beginning authorization date (MM/DD/YY) Ending authorization date (MM/DD/YY)*

Foreign country name, province/county, postal code

PART 3: TYPE OF AUTHORIZATION

GENERAL AUTHORIZATION

LIMITED AUTHORIZATIONSelect the type of authorization by checking the appropriate boxes.

1. Inspect or receive confidential information2. Represent me and make oral or written presentations of fact and argument3. Sign returns4. Enter into agreements5. Receive mail (includes forms, billings and payment notices)

PART 4: CHANGE IN POWER OF ATTORNEY REPRESENTATION OR REVOCATION

PART 5: TAXPAYER SIGNATURE(S)

If signed by a corporate officer, partner or fiduciary on behalf of the taxpayer, I certify that I have the authority to execute this Power of Attorney.Signature Name or title typed or printed Date

Spouse's signature Name or title typed or printed Date

* If no Ending Authorization date is provided, the above-named representative will be authorized to represent you until you notify the Income Tax Department in writing that this Power of Attorney is revoked.

Type of Income Tax Tax Form or Assessment Number Tax Year(s) or Period(s)

CHANGE IN POWER OF ATTORNEY REPRESENTATION: This form replaces all earlier powers of attorney, except those attached, on file for the same tax matters and years or periods covered by this Power of Attorney.

Complete this form if you wish to appoint someone to represent you to the Income Tax Department on income tax matters, or if you wish to revoke or change your current power of attorney authorization. Read the instructions on page 2 before completing this form.

Power of Attorney Authorization

REVOKE PREVIOUS AUTHORIZATION: I revoke all Powers of Attorney submitted and will represent myself in all tax matters. Attach copies of all Powers of Attorney that remain in effect concurrent with this new authorization.

Authorizes my representative to: (1) inspect or receive confidential information; (2) represent me and make oral or written presentations of fact and argument; (3) sign returns; (4) enter into agreements; (5) receive mail including forms, billings and payment notices. This authorization applies to all tax matters for all tax years or periods.

All Tax Matters

Only as Specified

Below



Revised 11/03/2014 City of {City Name}

Income Tax Department

INSTRUCTIONS FOR POWER OF ATTORNEY AUTHORIZATION Complete and file a Power of Attorney Authorization if you wish to appoint an individual, firm or organization as your representative in income tax matters before the Income Tax Department of the city noted above. Failure to complete this form will prohibit the Income Tax Department from discussing or releasing your tax return and/or tax return information with or to another person including your spouse. PART 1: TAXPAYER INFORMATION Enter the taxpayer’s name, address, telephone number, fax number and e-mail address (if applicable). If the taxpayer is a business operating under another name, enter the DBA, trade or assumed name. Enter the Social Security number(s), federal employer identification number (FEIN) or other account number, whichever applies. If spouses are designating the same representative, enter the spouse’s name, address (if different) and Social Security number. PART 2: REPRESENTATIVE INFORMATION AND AUTHORIZATION DATES You must send a separate Power of Attorney form for each different representative. Enter the authorized representative’s name firm’s name, address, telephone number, fax number, and e-mail address (if applicable). If your representative is not an individual, designate a contact person. Indicate the beginning and ending dates of authorization. PART 3: TYPE OF AUTHORIZATION Check the General Authorization box to allow your representative to act on your behalf to do all of the following: 1. Inspect and receive confidential information; 2. Represent you and make oral or written

presentations of fact and argument; 3. Sign returns; 4. Enter into agreements; and 5. Receive all mail including forms, billings and

payment notices. This authorization applies to all income tax matters for all years and tax periods. You may restrict your representative’s authorization to act on your behalf by checking the Limited Authorization box, and checking the appropriate boxes. To limit the authorization to specific income tax matters, check the appropriate “Only as Specified Below” boxes, and indicate the type of income tax, type of income tax form, and tax years or periods for which you are granting authorization in the space provided. 1. Check this box if your representative is authorized to

inspect or receive confidential information. 2. Check this box if your representative is authorized to

represent you and make oral or written presentation of fact and argument.

3. Check this box if your representative is authorized to sign tax returns.

4. Check this box if your representative is authorized to enter into agreements (such as payment plans).

5. Check this box if your representative is authorized to receive mail.

PART 4: CHANGE IN POWER OF ATTORNEY REPRESENTATION OR REVOCATION Unless otherwise specified, this Power of Attorney Authorization replaces and revokes any previous power of attorney authorizations on file with the Income Tax Department of the city noted above for the same tax matters identified on this form. You must identify any previous authorizations that are to remain in effect, and attach a copy of the authorizations to this form when filed. PART 5: TAXPAYER SIGNATURE You, and if a joint return, your spouse must sign and date the form. FILING Mail this form to: {Address listed in Appendix F for city named at top

of this page}



INCOME TAX WITHHOLDING COMMON FORMS FOR MICHIGAN CITIES

APPENDIX A ` Revised: 11/03/2015

Cities Accepting Common Form Withholding Tax Returns, Exemption Amounts and Tax Rates for Tax Year 2016

ALBION BATTLE CREEKBIG RAPIDSFLINTGRAND RAPIDSGRAYLING HAMTRAMCKHIGHLAND PARKIONIAJACKSONLANSING LAPEERMUSKEGONPONTIAC

PORTLANDSAGINAWSPRINGFIELDWALKER

* CITIES NOT ACCEPTING INCOME TAX WITHHOLDING COMMON FORMS

DETROIT *HUDSON *MUSKEGON HEIGHTS *

1/1/1971 $1,000 1.00% 0.50%

City Name

1/1/1967 $600 1.00% 0.50%

1.00% 0.50%

0.50%0.50%

Effective Date of Ordinance

20162016 Withholding Tax Rates

ExemptionAmount Resident Non-Resident

0.50%0.75%

City Name

$600 2.40%

1/1/1965 $600 1.00%7/1/1967 $600 1.50%

1/1/1994 $700 1.00%

7/1/1993 $600 1.00%

Effective Date of Ordinance

20162016 Withholding Tax Rates

ExemptionAmount Resident Non-Resident

0.50%7/1/1965

1.20%

0.50%1/1/1970 $600 1.00% 0.50%

1/1/1968 $6000.50%

1/1/1968 $600 1.00% 0.50%

CITIES ACCEPTING COMMON INCOME TAX WITHHOLDING FORMS

7/1/1962 $600 1.00% 0.50%1/1/1967 $600 2.00% 1.00%

7/1/1967 $750 1.00%1/1/1970 $600 1.00%

1/1/1972 $600 1.00% 0.50%

1/1/1972 $3,000 1.00% 0.50%

PORT HURON 1/1/1969 $600 1.00% 0.50%

1/1/1989 $600 1.00% 0.50%

1/1/1989 $750 1.00% 0.50%1/1/1988 $600 1.00% 0.50%

1/1/1984 $1,000 1.00%$750 1.50% 0.75%

1/1/1962




APPENDIX B Revised: 09/14/2015

Personal Exemptions Allowed

ALBIONBATTLE CREEKBIG RAPIDSDETROIT *FLINTGRAND RAPIDSGRAYLING HAMTRAMCKHIGHLAND PARKHUDSON *IONIAJACKSONLANSINGLAPEERMUSKEGONMUSKEGON HEIGHTS * PONTIACPORT HURONPORTLANDSAGINAWSPRINGFIELDWALKER

* Cities not accepting the income tax withholding common forms

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 X X

X X X X

X XCity Name Regular 65 & over Blind Deaf

Permanently Disabled

XX X X X X

XX X X X

X X X X X

X X X X X

X X X X XX X X X

X X X X XX X X X X

X X X X X X X X

X X X X X

Albion, Big Rapids, Highland Park and Pontiac do not allow a taxpayer to claim a personal exemption if the taxpayer is claimed as an exemption by another taxpayer on that city's income tax return.

An employee or spouse who is 65 years of age or older may not claim the exemption for being permanently disabled.




APPENDIX C Revised: 11/03/2015

Withholding Deposit Requirements

Quarterly deposits are required for cities electing Sections 60 and 61 (MCL 141.660 and MCL 141.661)

CITIES ACCEPTING COMMON INCOME TAX WITHHOLDING FORMS

ALBION

* CITIES NOT ACCEPTING INCOME TAX WITHHOLDING COMMON FORMS

ALBION *DETROIT *HUDSON *MUSKEGON HEIGHTS *

WALKER

City Name

XX

XXPORT HURON

Quarterly Deposits Required

Monthly and Quarterly Deposits Required

(See above)

XX

XXXX

XX

City Name

GRAYLING

BIG RAPIDSFLINT

BATTLE CREEK

GRAND RAPIDS

PONTIACMUSKEGON

LANSING

HAMTRAMCKHIGHLAND PARK

LAPEER

IONIAJACKSON

Monthly and Quarterly Deposits Required

(See above)

XX

XX

XX

XXXX

XX

XX

XXXX

XXXXXXXX

Monthly and quarterly deposits are required for cities electing alternative Sections 60 and 61 (MCL 141.760 and MCL 141.761). Employers whose total withholding for the first or second month of a quarter exceeds $100 are required to make a monthly deposit of the tax withheld for the month and are required to make a quarterly deposit of income tax withheld for the quarter not previously deposited for the first or second month of the quarter

Monthly Reporting Optional

XX

Monthly Reporting Optional

XX

XX

XX

XXXX

SAGINAWSPRINGFIELD

PORTLAND

XX

XX

Quarterly Deposits Required



INCOME TAX WITHHOLDING COMMON FORMS FOR MICHIGAN CITIESRevised 11/03/2015

APPENDIX D

Authorized City Name Abbreviations to Use for Completing Form W-2, Box 20, Locality Name and Related RS Record Data for EFW2 Transmittals

ALBION MIALB MI-ALB MIALBnnnnnBATTLE CREEK MIBCK MI-BCK MIBCKnnnnnBIG RAPIDS MIBRR MI-BRR MIBRRnnnnnDETROIT * MIDET MI-DET not availableFLINT MIFLT MI-FLT MIFLTnnnnnGRAND RAPIDS MIGRR MI-GRR MIGRRnnnnnGRAYLING MIGRA MI-GRA MIGRAnnnnnHAMTRAMCK MIHAM MI-HAM MIHAMnnnnnHIGHLAND PARK MIHPK MI-HPK MIHPKnnnnnHUDSON * MIHUD MI-HUD MIHUDnnnnnIONIA MIION MI-ION MIIONnnnnnJACKSON MIJAC MI-JAC MIJACnnnnnLANSING MILNS MI-LNS MILNSnnnnnLAPEER MILPR MI-LPR MILPRnnnnnMUSKEGON MIMKG MI-MKG MIMKGnnnnnMUSKEGON HEIGHTS * MIMHT MI-MHT MIMHTnnnnnPONTIAC MIPNT MI-PNT MIPNTnnnnnPORT HURON MIPHN MI-PHN MIPHNnnnnnPORTLAND MIPOR MI-POR MIPORnnnnnSAGINAW MISAG MI-SAG MISAGnnnnnSPRINGFIELD MIMHT MI-SPR MISPRnnnnnWALKER MIWAL MI-WAL MIWALnnnnn


COLUMN D EFW2 RS RECORD DATA LOCATIONS 298-307 (n=BLANK)

"MI{CN}nnnnn"

COLUMN C 6 CHARACTER

ABBREVIATION FOR PRINTED FORM W-2

FOR MIICHIGAN CITIES

MICHIGAN CITIES LEVYING AN INCOME

TAXCOLUMN A CITY NAME

COLUMN B 5 CHARACTER

ABBREVIATION FOR PRINTED FORM W-2 FOR

MIICHIGAN CITIES

AUTHORIZED LOCALITY NAME ABBREVIATIONS FOR USE IN FORM W-2, BOX 20 (LOCALITY NAME) AND EFW2 RS RECORD LOCATIONS 298-307



INCOME TAX WITHHOLDING COMMON FORMS FOR MICHIGAN CITIESRevised: 11/03/2015

APPENDIX E

ALBIONBATTLE CREEKBIG RAPIDSDETROIT *FLINTGRAND RAPIDSGRAYLING HAMTRAMCKHIGHLAND PARKHUDSON *IONIAJACKSONLANSINGLAPEERMUSKEGONMUSKEGON HEIGHTS * PONTIACPORT HURONPORTLANDSAGINAWSPRINGFIELDWALKER


WAL

PORSAGSPR

MHTPNTPHN

LNSLPRMKG

HUDIONJAC

GRAHAMHPK

GRR

ALBBCKBRRDET

Three Character City Name Abbreviation

City Name3 Character City

Name {CN} Abbreviation

FLT




APPENDIX F Revised: 11/16/2015

Cities Accepting ACH Debit or Credit Withholding Deposits in lieu of Paper Returns; and Cities Accepting Forms W-2 Using Common Form CD-ROM format (See Appendix F for the city's website address and go to the website for Instructions and File Specifications)

ALBIONBATTLE CREEKBIG RAPIDSDETROIT *FLINTGRAND RAPIDSGRAYLING HAMTRAMCKHIGHLAND PARKHUDSON *IONIAJACKSONLANSINGLAPEERMUSKEGONMUSKEGON HEIGHTS *PONTIACPORT HURONPORTLANDSAGINAWSPRINGFIELDWALKER


Accepting Forms W-2 Using EFW2

Format on CD-ROM

Yes

City NameAccepting ACH

Credit Payments

Yes

Accepting ACH Debit Payments

YesNoNo

Contact City

YesNo

Contact CityNoYesNo

NoYesNo

NoNo

Contact City

NoNo

Contact CityNoNoYes

NoNoYes

NoNo

Contact City

NoNo

Contact CityNoNoNo

NoNoNo

NoNoYes

NoNoYes

Yes

YesYes

Contact CityYesYesNoYesYes

Contact CityYesyes

YesYesYes

YesYes

Contact CityYesYesYes



INCOME TAX WITHHOLDING COMMON FORMS FOR MICHIGAN CITIES Revised: 11/03/2015

APPENDIX G

Mailing Addresses for Mailing Returns to Cities Accepting the Withholding Tax Common Form

City of Albion Income Tax Division112 W Cass StAlbion MI 49224-0900

Battle Creek City Income TaxPO Box 1657Battle Creek MI 49016-1657

City of Big Rapids Treasurer's Office226 North Michigan AveBig Rapids MI 49307

City of Big Rapids Income Tax Office226 North Michigan AveBig Rapids MI 49307

City of Flint Income Tax DepartmentPO Box 529Eaton Rapids MI 48827-0529

Grand Rapids Income Tax DeptPO Box 347Grand Rapids MI 49501-0347

Albion

XX XX XX XX XX XX XX XX

Grand Rapids XX XX XX XXXX XX XX XX

XXXX XX

XXXX XX XX XXXX XX XX

XX XX XX XX XX

CITY MAILING ADDRESS

USE MAILING ADDRESS FOR WITHHOLDING TAX FORMS OR PAYMENTS

Prior Year Forms

CF-501 or CF-941

Prior Year Amended

Withholding Tax Return

Forms

Power of Attorney

Authorization

Form CF-501

Form CF-941

Form CF-W-3 and Forms W-2 without

Payment

Form CF-W-3 and Forms W-2 with Payment

Form CF-IT-6, Notice of

Change or Discontinuance

Battle Creek

XX

Big Rapids

XX XX XX XX XX XXXX

Flint




APPENDIX G




Prior Year Forms

CF-501 or CF-941

Prior Year Amended


Forms

Power of Attorney

Authorization

Form CF-501

Form CF-941


Payment




City of Grayling Income Tax DivisionPO Box 549Grayling MI 49738

City of Hamtramck Income Tax DivPO Box 209Eaton Rapids MI 48827-0209

City of Highland Park Income Tax DivPO Box 239Eaton Rapids MI 48827-0239

City of Ionia Income Tax DivisionPO Box 512Ionia MI 48846

City of Jackson Income Tax Division161 W Michigan AveJackson MI 49201

City of Lansing Income Tax Dept124 W Michigan Ave Rm G-29Lansing MI 48933

XX

Highland Park

Lansing

XX XX XX XXXX XX XX

XX XX

Jackson

XXXX XX XX XX XX

XX XX

XX XX XX XX XX XX

XX

Ionia

XX XX XX XX XX XXXX

XXXX XX XX XX XX

Hamtramck

XX XX XX XX XX

Grayling

XX XX

XX XX XX




APPENDIX G




Prior Year Forms

CF-501 or CF-941

Prior Year Amended


Forms

Power of Attorney

Authorization

Form CF-501

Form CF-941


Payment




City of Lapeer Income Tax Department576 Liberty ParkLapeer MI 48446-2140

City of Muskegon Income Tax DeptPO Box 29Muskegon MI 49443-0029

City of Pontiac Income Tax DivisionPO Box 530Eaton Rapids MI 48827-0530

City of Port Huron Income Tax Division100 McMorran BlvdPort Huron, MI 48060

City of Portland Income Tax Dept259 Kent StPortland MI 48875

City of Saginaw Income Tax Office1315 S Washington AveSaginaw MI 48601

XX

Saginaw

XX XX XX XX XX XXXX

XXXX XX XX XX XXXX XX

Muskegon

XX XX XX XX XX XXXX

Lapeer

XX XX XX XX XXXX XX

Pontiac

XX XX XX XXXX XX XX XX

XX

XX

XX

Portland

Port Huron

XX XX XX XX XX XX XX




APPENDIX G




Prior Year Forms

CF-501 or CF-941

Prior Year Amended


Forms

Power of Attorney

Authorization

Form CF-501

Form CF-941


Payment




City of Springfield Income Tax Dept601 Avenue ASpringfield MI 49037-7774

Walker City Income Tax DeptPO Box 153Grand Rapids MI 49501-0153

* Mailing Addresses for Mailing Returns to Cities Not Accepting the Withholding Common Form

Treasurer City of Detroit - Income TaxP.O. Box 67000Detroit, Michigan 48267-1319

City of Detroit - Income TaxColeman A. Young Municipal Center2 Woodward Avenue, Suite 1220Detroit, MI 48226

Hudson City Income Tax DivisionPO Box 231Hudson MI 49247

Muskegon Heights Income Tax Division2724 Peck StMuskegon Heights MI 49444

Hudson *

Detroit does not accept withholding tax common forms. Contact the Detroit Income Tax Department for forms, specifications and filing instructions.

Hudson does not accept withholding tax common forms. Contact the Hudson Treasurer's Office for forms, specifications and filing instructions.

XX XX XX XXXX XX XX XX

Detroit *

Walker

Detroit does not accept withholding tax common forms. Contact the Detroit Income Tax Department for forms, specifications and filing instructions.

Muskegon Heights *

Springfield

XXXX XX XX XX

Muskegon Heights does not accept withholding tax common forms. Contact the Muskegon Heights Treasurer's Office for forms, specifications and filing instructions.

XX XX XX




APPENDIX H

Withholding Tax Contacts for Michigan Cities Levying a City Income Tax

ALBIONBATTLE CREEKBIG RAPIDSDETROIT *FLINTGRAND RAPIDSGRAYLING HAMTRAMCKHIGHLAND PARKHUDSON *IONIAJACKSONLANSINGLAPEERMUSKEGONMUSKEGON HEIGHTS *PONTIACPORT HURONPORTLANDSAGINAWSPRINGFIELDWALKER


ALBION [email protected] Sharon FarmerBATTLE CREEK [email protected] Vicki KammerudBIG RAPIDS [email protected] Paul Cole or Amy PrescottDETROIT *FLINTGRAND RAPIDS [email protected] Jeni Frost or Jennifer Woodard GRAYLING HAMTRAMCKHIGHLAND PARKHUDSON *IONIA [email protected] [email protected] Lisa SkalskiLANSING [email protected] Brenda SmithLAPEER [email protected] Kaye HodgesMUSKEGON [email protected] Ken GrantMUSKEGON HEIGHTS *PONTIACPORT HURON [email protected] [email protected] Kelly SheltrawSPRINGFIELD Virginia KarasWALKER


www.detroitmi.govwww.cityofflint.com

(231) 724-6768

Telephone Number

(231) 592-4012(313) 224-9596(810) 766-7015

(616) 456-3415 Ext. 4(989) 348-2131 Ext. 30

(616) 456-4540

(517) 788-4044(517) 483.4117(810) 667-7155(231) 724-6770

(517) 483-6084

www.cityofmuskegonheights.orgwww.pontiac.mi.us

Withholding Tax City Name

(517) 629-7865(269) 966-3345

www.cityofjackson.orgwww.lansingmi.govwww.ci.lapeer.mi.us

www.muskegon-mi.gov

www.grcity.us/incometaxwww.cityofgrayling.org

Website Address for Citywww.cityofalbionmi.govwww.battlecreekmi.gov

www.cityofbr.org

www.saginaw-mi.com

www.porthuron.orgwww.portland-michigan.org

www.springfieldmich.comwww.ci.walker.mi.us

(231) 733-8812(248) 758-3236(810) 984-9741(517) 647-2941(989) 759-1655

(810) 667-7157

(313) 603-3118www.hamtramck.us

www.highlandparkcity.orgwww.ci.hudson.mi.us

www.ci.ionia.mi.us/taxes(616) 523-0142

(269) 965-8211(616) 791-6869(269) 965-8324

Fax Number

(616) 527-0810

(269) 966-3329(231) 5924011

(517) 663-6141

(517) 663-6141(517) 663-6141(517) 448-7339(517) 448-8983

(313) 870-9366

(517) 663-6141

(989) 759-1467

E-mail Address for CityWithholding Tax

Contact personCity Name




APPENDIX I

EXAMPLE

TAX CODE (PAYMENT CODE)

EMPLOYER FEIN WITHHOLDING TAX PAYMENT

TAX TYPE (PAYMENT TYPE)

JANUARY WITHHOLDING TAX PAYMENT FEBRUARY WITHHOLDING TAX PAYMENT 1ST QTR (MARCH) WITHHOLDING TAX PAYMENT APRIL WITHHOLDING TAX PAYMENT MAY WITHHOLDING TAX PAYMENT 2ND QTR (JUNE) WITHHOLDING TAX PAYMENT JULY WITHHOLDING TAX PAYMENT AUGUST WITHHOLDING TAX PAYMENT 3RD QTR (SEPTEMBER) WITHHOLDING TAX PAYMENT OCTOBER WITHHOLDING TAX PAYMENT NOVEMBER WITHHOLDING TAX PAYMENT 4TH QTR (DECEMBER) WITHHOLDING TAX PAYMENT

ACTUAL DATA STREAMS FOR A MONTHLY WITHHOLDING TAX PAYMENT USING FORM CF-501 WITH AND WITHOUT PAYMENT AMOUNT

GRR123456789W2201694101M1234567890GRR123456789W2201694101M

ACTUAL DATA STREAMS FOR A QUARTERLY WITHHOLDING TAX PAYMENT USING FORM CF-941 WITH AND WITHOUT PAYMENT AMOUNT

GRR123456789W2201694101Q1234567890GRR123456789W2201694101Q

DATA STREAM CHARACTERSEXPLANATION3 CHARACTER CITY NAME (CN) ABBREVIATION FROM APPENDIX HNINE DIGIT SSN/FEIN (TAXPAYER IDENTIFICATION NUMBER)ONE CHARACTER SSN/FEIN INDICATORCHECK DIGITFOUR DIGIT TAX YEARSIX CHARACTER TAX CODE AND TAX TYPE (Three character Tax Code plus three character Tax Type)PAYMENT AMOUNT (Right justified; Zero filled on left; Last two digits are cents; No decimal point)PAYMENT DATE (Reserved for future development)ROUTING NUMBER (Reserved for future development)BANK ACCOUNT NUMBER (Right justified; Zero filled on left) (Reserved for future development)BANK ACCOUNT TYPE (Reserved for future development)

OCR Scan Line Specifications for Withholding Tax Return Forms, CF-501, CF-941 or CF-W-3

CITY SSN/FEIN (TAX ID)SSN/FEIN CHECK

DIGIT *TAX

YEARTAX CODE PLUS TYPE

PAYMENT ROUTING

123456

ANK ACCOUN TYPE OFINDICATOR DATE NUMBER NUMBER ACCOUNT

123 1 1 1234

GRR 123456789 W 2 2016 C

12,345,678.90 MMDDYYYY ######## 4567891234 1

94101M 1234567890 04012015 ######## 4567891234

PAYMENT AMOUNT

941 01Q

SSN/FEIN INDICATOR

FOR CHECK DIGIT SPECIFICATIONS SEE APPENDIX N

03Q

941 10M

941

08M

TAX CODE

941

TAX CODE TAX TYPE

*941 01M

941 02M

11M

W

123456789

04Q

THE SCAN LINE DATA STREAM MAY BE IN 10 OR 12 POINT "OCR A" FONT

04M

941 05M

941 02Q

941 07M

941

69

15 THROUGH 1819 THROUGH 2425 THROUGH 3435 THROUGH 4243 THROUGH 5152 THROUGH 68

14

941

941

CHARACTER1 THROUGH 34 THROUGH 12

13

941



INCOME TAX WITHHOLDING COMMON FORMS FOR MICHIGAN CITIES Revised 09/04/2015

APPENDIX J

TAX ID CHECK DIGIT SPECIFICATIONS

CHARACTERS DESCRIPTION EXPLANATION

1 TO 9 9 DIGIT TAX ID

10

11 CHECK DIGIT AS COMPUTED IN EXAMPLES BELOW

CHARACTER TRANSLATION SCHEMEINPUT VALUE 0 1 2 3 4 5 6 7 8 9 A B C D E F G H I J KTRANSLATION VALUE 0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 10 11

INPUT VALUE L M N O P Q R S T U V W X Y Z - # $ * & /TRANSLATION VALUE 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 0 0 0 0 0 0

WEIGHTS: 3, 5, 7, 9 REPEATED THROUGHOUT FOR NUMBER OF CHARACTERS

EXAMPLE OF CHECK DIGIT CALCULATION FOR SSN OR ITIN EXAMPLE OF CHECK DIGIT CALCULATION FOR TRUST FEINCHARACTER PLACE 1 2 3 4 5 6 7 8 9 10 CHARACTER PLACE 1 2 3 4 5 6 7 8 9 10CHARACTER VALUE 3 2 1 6 5 4 7 8 9 0 CHARACTER VALUE 1 2 3 4 5 6 7 8 9 20CHARACTER WEIGHT 3 5 7 9 3 5 7 9 3 5 CHARACTER WEIGHT 3 5 7 9 3 5 7 9 3 5VALUE x WEIGHT 9 10 7 54 15 20 49 72 27 0 VALUE x WEIGHT 3 10 21 36 15 30 49 72 27 100

SUM OF VALUE x WEIGHT SUM OF VALUE x WEIGHTMODULUS 10 263 / 10 = 26 REMAINDER 3 MODULUS 363 / 10 = 36 REMAINDER 3

REMAINDER FROM 10 REMAINDER FROM 10

CHECK DIGIT 7 CHECK DIGIT 7

EXAMPLE OF CHECK DIGIT CALCULATION FOR CORPORATION FEIN EXAMPLE CHECK DIGIT CALCULATION FOR WITHHOLDING TAX FEINCHARACTER PLACE 1 2 3 4 5 6 7 8 9 10 CHARACTER PLACE 1 2 3 4 5 6 7 8 9 10CHARACTER VALUE 3 2 1 6 5 4 7 8 9 3 CHARACTER VALUE 3 2 1 6 5 4 7 8 9 23CHARACTER WEIGHT 3 5 7 9 3 5 7 9 3 5 CHARACTER WEIGHT 3 5 7 9 3 5 7 9 3 5VALUE x WEIGHT 9 10 7 54 15 20 49 72 27 15 VALUE x WEIGHT 9 10 7 54 15 20 49 72 27 115

SUM OF VALUE x WEIGHT SUM OF VALUE x WEIGHTMODULUS 10 278 / 10 = 27 REMAINDER 8 MODULUS 10 378 / 10 = 37 REMAINDER 8

REMAINDER FROM 10 REMAINDER FROM 10

CHECK DIGIT 2 CHECK DIGIT 2

SSN (Social Security Number), ITIN (Individual Taxpayer Identification Number) or FEIN (Federal Employer Identification Number)

TAX ID TYPE INDICATOR FOR AN SSN, ITIN OR FEIN

POSSIBLE CHARACTERS ARE 0, C, T & W (0 = SSN OR ITIN, C = Corporation or Partnership FEIN, T = Estate or Trust FEIN & W = Employer Withholding Tax FEIN)

363

10 - 3 = 7 (REMAINDER OF 0 MAKES CHECK DIGIT = 0)


378



263

278



INCOME TAX WITHHOLDING COMMON FORMS FOR MICHIGAN CITIES Revised 10/28/2015

Appendix K Specifications for Employer Electronic Media Filing of Local (City) Forms W-2 Acceptable standards for Michigan cities accepting electronic media filing of Forms W-2:

1. The Social Security Administration, Specifications for Filing Forms W-2 Electronically (EFW2) For Tax Year 2015, Publication Number 42-007 (number 1 below); or

2. The CityTax Proprietary Format (number 2 below).

How to Report Wages and Income Tax Withheld

1. Federal EFW2 Format (EFW2 Tax Year 2015):

a. Data is to be submitted via CD-ROM and the file must be: (Transmission of data via any other media is strictly prohibited unless an alternative method is approved by the City.) 1) In a fixed length MS-DOS ASCII file format; 2) Named “W2REPORT” with no file extension; and 3) In the root directory.

b. Records Specifications are found on Page 15 of the EFW2 for tax year 2015. The specifications for electronic media filing of local Forms W-2 are the same as specifications published by the Social Security Administration except for fields in the RS record (State Wage Record) defined by the State/local agency.

c. Transmitters of W-2 information for multiple employers can avoid creating a separate file for each employer by using the EFW2 for tax year 2015 specifications. Review Appendix C, example 10, page 82, to see how multiple employers can be combined into one file.

d. Data rules can be found on page 15 of EFW2 for tax year 2015.

e. Required and Optional Records:

Include the RA, RE, RW, RO, RS, RT, RU and RF records when using the EFW2 format. The employer records should include only records pertaining to the particular city’s income tax. The RS records should include only local tax information for the particular city.

RA − Submitter Record (Required) This record should be the same as the record submitted to the Social Security

Administration.

RE − Employer Record (Required) This record should be the same as the record submitted to the Social Security

Administration.

RW − Employee Wage Record (Required) This record should be the same as the record submitted to the Social Security

Administration. Include RW records for all employees who worked and/or conducted business on behalf of their employer in the city.

RO − Employee Wage Record (Optional)



1. Federal EFW2 Format: (Continued)

RS − State Record (Required) a. This record should be the same as the record submitted to the Social Security

Administration. Include RS records for:

1) All employees from whom tax was withheld for the particular city;

2) All employees who are residents of the particular city regardless of where they worked for the employer; and

3) All employees who are nonresidents of the particular city and worked or conducted business on behalf of the employer in the particular city.

b. Specifications for RS record fields defined by State/local agency:

RS POSITION

FIELD NAME LENGTH FIELD SPECIFICATIONS

5-9 Taxing Entity Code 5 To be defined by State/Local agency. Left Justified and blank filled. Identify the city for which tax was withheld using the abbreviation listed for the city in Appendix D, column B. Applies to income tax reporting.

298-307 Other state data Locality Name (Form W-2, box 20)

10 To be defined by State/Local agency. Left Justified and blank filled. Identify the city for which tax was withheld using the abbreviation listed for the city in Appendix D, column D. Applies to income tax reporting.

309-319 Local taxable wages (Form W-2, box 18)

11 To be defined by State/Local agency. Right justified and zero filled Applies to income tax reporting.

320-330 Local income tax withheld (Form W-2, box 19)

11 To be defined by State/Local agency Right justified and zero filled. Include only income tax withheld for the particular city. Applies to income tax reporting.

The code used by your accounting system to identify the particular city as the locality for which tax was withheld is meaningless to the city.

RT − Total Record (Required) This record should be the same as the record submitted to the Social Security

Administration except include totals for only the RS records for all employees who worked and/or conducted business on behalf of their employer in the particular city.

RU − Total Record (Optional)

RF − Final Record (Required)

RV – State Total Record (Optional)

2. CityTax Proprietary Format (CTP):

(This is a comma-delimited format. See instructions for creating this file in Microsoft Excel under section e below.)



a. Data is to be submitted via CD-ROM and the file must be: 1) In comma delimited MS-DOS ASCII file format;

2) Named “W2REPORT” with a “.CSV” file extension; and

3) In the root directory.

b. First row: Employer Record Specifications

Column Data Explanation A CTE Text exactly as shown. Identifies as employer

record.

B Employer EIN of Tax ID 9 digits no spaces or punctuation

C Tax year 4 digits

D Employer name

E C or blank C if corporation, blank otherwise

F Employer street address No punctuation or commas in address

G Employer city

H Employer state 2 character state abbreviation

I Employer Zip Code 5 digits (6 characters if foreign address)

J Employer Zip Plus 4 4 digits

c. Employee rows: Employee Record Specifications (One row per employee)

Column Data Explanation A CTW Text exactly as shown. Identifies as employee

record.

B Employee SSN 9 digits no spaces or punctuation

C Employee Last Name

D Employee First name

E Employee Middle Initial

F Employee Street Address

No punctuation or commas in address

G Employee City

H Employee State 2 character state abbreviation

I Employee Zip Code 5 digits (6 characters if foreign address)

J Employee Zip Plus 4 4 digits

K Employee total wages Same as Form W-2, box 1. Format as number with two decimal places; do not use 1000 Separator (,). If no wages zero fill field.

L Local Entity Code Same as Form W-2, box 20. Identify the city for which tax was withheld using the abbreviation listed for the city in Appendix D, column D.



M City Income Tax Withheld

Same as Form W-2, box 19. Format as number with two decimal places; do not use 1000 Separator (,). If no withholding zero fill field.

d. End of data marker. In row after the last row of employee data, enter in column A ‘ZZZ’

as the end of data marker. e. How to Create CTP formatted file using Microsoft Excel.

1) Open a new spreadsheet.

2) All entries are to be made in upper case letters.

3) In the first row, enter the employer data as specified above. Enter one value per column. Skip a column if blank. Start by entering ‘CTE’ on the first line in column A. Enter the remaining employer data items one per column.

4) In the second row and each subsequent employee row necessary thereafter, enter the employee data as specified above. Enter ‘CTW’ in column A. Enter the remaining employee data items one item per column. If a data item is blank, skip the corresponding column. The employee records should include only local tax information for:

i. All employees from whom tax was withheld for the particular city;

ii. All employees who are residents of the particular city regardless of where they worked for the employer; and

iii. All employees who are nonresidents of the particular city and worked or conducted business on behalf of the employer in the particular city.

5) On the row after the last line of employee data, enter in column A ‘ZZZ’ as an end of data marker.

6) When done entering employee data, click on the Save button (or select Save from the file menu). At the bottom of the save window is a drop down box titled, Save as type. Click on this drop-down and select, ‘CSV (Comma delimited)(*.csv). Enter the file name, ‘W2REPORT’ and then click on the save button.

3. Marking of CR-ROM’s: Mark all CD-ROM’s submitted with the name of the taxpayer, the taxpayer’s tax ID, the tax year of the Forms W-2, and the sequential number if more than one CD-ROM is necessary.

4. Filing of Form CFW-3, Employer’s Annual Reconciliation of Income Tax Withheld

An employer filing W-2’s on CD-ROM must submit Form CFW-3, Employer’s Annual Reconciliation of Income Tax Withheld, with the magnetic media.

a. Tax due upon reconciliation, as reported on Form CFW-3, line 6, must be paid when the reconciliation and CD-ROM are submitted.

b. Refund of an overpayment of tax withheld, as reported on Form CFW-3, line 7, will be made only upon the employer’s submission of a letter requesting a refund of the overpayment and providing a detailed explanation of the cause of the overpayment. The request for refund should be attached to the Form CFW-3 submitted to the city.

5. Mail the CD-ROM with Form CFW-3 to the address listed for the City in Appendix G

6. Questions: All questions about electronic media filing of Forms W-2 with a city must be directed to that particular city. Refer to Appendix H city contact information.



COMMON INCOME TAX WITHHOLDING Revised 09/11/2015 APPENDIX L

WITHHOLDING TAX SECTIONS OF THE

MICHIGAN UNIFORM CITY INCOME TAX ORDINANCE (MCL 141.601 et seq) AND THE REGULATIONS ADOPTED BY MOST MICHIGAN CITIES

141.605 Doing business; definition; solicitation of orders and storage excepted Sec. 5. "Doing business" means the conduct of any activity with the object of gain or benefit, except that it does not include: (a) The solicitation of orders by a person or his representative in the city for sales of tangible personal property, which orders are sent outside the city for approval or rejection and, if approved, are filled by shipment or delivery from a point outside the city. (b) The solicitation of orders by a person or his representative in the city in the name of or for the benefit of a prospective customer of a person, if orders by the customer to such person to enable the customer to fill orders resulting from the solicitation are orders described in paragraph (a). (c) The mere storage of personal property in the city in a warehouse neither owned nor leased by the taxpayer. Reg. 5.1. A person shall not be considered to be doing business in the city, in the absence of maintaining an establishment in the city or engaging in other activity in the city, merely by engaging in one or more of the following acts: (a) maintenance, by a corporation, of a resident agent in the city; (b) installing, servicing, or instructing in the use of equipment or other goods sold when performed by an employee-salesman of such person and where such activities are incidental to the employee-salesman's primary selling activities; (c) occasional credit investigations or collections by an employee-salesman of such person where such activities are incidental to the employee-salesman's primary selling activities; (d) exhibiting goods for a short time, in leased space, at a convention, exhibition or trade show; (e) mere ownership of real or tangible personal property in the city which is not used in or related to business activity in the city and which does not produce gross income in the city. 141.608 Definitions; predominant place of employment Sec. 8. (3) "Predominant place of employment" means that city imposing a tax under a uniform city income tax ordinance other than the city of residence, in which the employee estimates he will earn the greatest percentage of his compensation from the employer, which percentage is 25% or more. MCL 141.651 Tax withheld; rates for residents and nonresidents; employer as trustee; liability for taxes, penalties, interest Sec. 51. (1) An employer doing business or maintaining an establishment within the city shall withhold from each payment to the employer's employees on and after the effective date of this



ordinance the tax on their compensation subject to the tax, after giving effect to exemptions, as follows: (a) Residents. (i) At a rate equal to the rate set by ordinance to be levied against resident individuals under this ordinance, but not to exceed 3% of all compensation paid to the employee who is a resident of the city, if the employee is not subject to withholding in any other city levying the tax. (ii) At a rate equal to the difference in the percentage rate of tax on resident individuals as set by ordinance to be levied under this ordinance less the percentage rate of tax levied by any other city in which the employee works, on all compensation earned by the resident in another city. (b) Nonresidents. At a rate equal to the rate set by ordinance to be levied under this ordinance on nonresidents but not to exceed 50% of the percentage rate imposed on resident individuals of the compensation paid to the employee for work done or services performed in the city designated by the employee as the employee's predominant place of employment. The withholding rate shall be applied to the percentage of the employee's total compensation equal to the employee's estimated percentage of work to be done or services to be performed in the city for that employer, but no withholding shall be required if the estimated percentage of work is less than 25%. (2) An employer withholding the tax is deemed to hold the tax as a trustee for the city. (3) An employer who is required to withhold and who fails or refuses to deduct and withhold is liable for the payment of the amount required to be withheld. The liability shall be discharged upon payment of the tax by the employee but the employer is not relieved of penalties and interest provided in this ordinance for this failure or refusal. (Amended by Act 60 of 1981, effective June 5, 1981; Amended by Act 124 of 1982, effective April 19, 1982.) Reg. 51.1 In determining whether the tax shall be withheld from musicians, entertainers, athletes and other such individuals the definition of employee in Sec. 6(1) of the ordinance shall be controlling. ("Employee" means a person from whom an employer is required to withhold for either federal income or federal social security taxes.) Reg. 51.2 An employer, whether or not an individual, and whether or not a resident of the city, who maintains a business establishment or business establishments in the city and a business establishment or business establishments outside the city must withhold the tax from all residents working at such employer's out-of-city establishment or establishments. Reg. 51.3 Compensation subject to withholding shall include wage and salary advances, and advances on commissions. MCL 141.652 Same; payments excepted Sec. 52. Employers shall not withhold any tax from the following payments or persons: (a) Compensation paid to domestic help. (b) Compensation paid to a person who is not an employee, including an independent contractor. (c) An amount allowed and paid to an employee as reimbursement for expenses necessarily and actually incurred by the employee in the actual performance of his or her services, and deductible by the employer. (d) A qualified taxpayer. "Qualified taxpayer" means that term as defined in section 35(12)(c)(i).



(Amended by Act 442 of 1996, effective Dec. 19, 1996) Reg. 52.1 An employer who directly makes wage continuation payments for personal injuries, sickness or disability may elect to withhold or not withhold the tax on the exempt portion of such payments. In either case the amount of exempt income shall be included in the total amount of compensation reported on the annual information return required of all employers under Section 61(2) of this ordinance, either as part of total wages paid or as a separate figure. MCL 141.653 Same; payment by employee or employer Sec. 53. If the tax is not withheld, an employee is not excused from filing a return and paying the tax on his compensation. If the tax is withheld but an employer fails to pay the tax to the city, the employee is not liable for the tax so withheld. MCL 141.654 Same; exemptions claimed; percentage of work done at predominant place of employment; qualified taxpayer within renaissance zone Sec. 54. An employee with compensation subject to tax shall file with his or her employer a form on which the employee states the number of exemptions claimed, the city of residence, the predominant place of employment, whether or not the employee claims status as a qualified taxpayer of a renaissance zone, and the percentage of work done or services performed in the predominant place of employment. The percentage shall be expressed as "less than 25%", "40%", "60%". "80%" or "100%". The employer shall retain the form, rely on the information on the form for withholding purposes unless directed by the city to withhold on another basis, and, if the employee claims status as a qualified taxpayer based on residency in a renaissance zone, the employer shall forward a copy of the form to the city. If information submitted by the employee is not believed to be true, correct and complete, the city shall be so advised. As used in this section, "Renaissance zone" means that term as defined in section 35. (Amended by Act No. 442 of 1996, effective Dec. 19, 1996) MCL 141.655 Same; revised form, time for filing; qualified taxpayer within renaissance zone Sec. 55. (1) Except as provided in subsection (2), an employee shall file with his or her employer a revised form within 10 days after the number of exemptions decreases when a change in residence from or to a taxing city occurs. The employee may file a revised form when the number of exemptions increases. An employee shall file a revised form by December 1 of each year, if his or her predominant place of employment, estimate of the percentage of work done or services to be rendered in the city, or status as a qualified taxpayer of a renaissance zone will change for the ensuing year. Revised withholding certificates shall not be given retroactive effect. (2) An employee shall file a revised form with his or her employer within 10 days after the employee completes the residency requirements under section 35(12), and when a change of status occurs from resident of a renaissance zone to nonresident of a renaissance zone. The employer shall forward a copy of a revised form filed under this subsection to the city. (3) As used in this section, "renaissance zone" means that term as defined in section 35. (Amended by Act 442 of 1996, effective Dec. 19, 1996)



MCL 141.656 Same; refusal to furnish withholding certificate, rate of tax Sec. 56. If an employee refuses to furnish a withholding certificate upon the request of his or her employer, the employer shall withhold a percentage of the employee's total compensation equal to the percentage rate of tax on resident individuals as set by ordinance to be levied under this ordinance, and report and pay the withholding on the basis of the best information in the possession of the employer. (Amended by Act 60 of 1981, effective June 5, 1981; Amended by Act 124 of 1982, effective April 19, 1982.) MCL 141.657 Same; withholding tables; first compensation taxable Sec. 57. (1) The city shall provide withholding tables establishing the amounts to be withheld for various tax rates, wage brackets, numbers of exemptions and pay periods. An employer who uses the tables fully discharges his duty to withhold. An employer may elect not to use the tables, in which case to discharge fully his duty to withhold he shall withhold the applicable per cent of taxable compensation after provision for exemptions. (2) The first compensation paid an employee on or after the effective date of the tax levy is subject to withholding on either of the following bases at the option of the employer: (a) On the full amount of compensation paid. (b) On the proportion of compensation paid for work done or services performed on or after the effective date of the levy. MCL 141.658 Same; overwithheld tax, refund Sec. 58. If an employer withholds more than the apparent tax liability of an employee due to an increase in the number of exemptions claimed during the year, or due to the actual percentage of work performed in the city by a nonresident being less than the estimated percentage, or due to a change of residence during the year to or from a taxing city, or due to any reason other than the employer's error, the employer shall neither refund the excess to the employee nor offset the excess by under-withholding in a subsequent period. The employee shall claim his refund from the city on his annual return. MCL 141.659 Same; correction of error, refund Sec. 59. Correction of an over or an under-withholding as a result of an employer's error shall be made as follows: (a) If the error is discovered in the same quarter in which it is made, the employer shall make the necessary adjustment on a subsequent pay and include only the corrected amount on the quarterly return. (b) If the error is discovered in a subsequent quarter of the same calendar year, the employer shall make the necessary adjustment on a subsequent pay and report it as an adjustment on the quarterly return. (c) If the error is discovered in the following calendar year, or if the employer-employee relationship has terminated, the procedure shall be as follows: (i) The employee or former employee shall apply to the city for a refund in case of an over-withholding. Upon proper verification the city shall refund to him the amount of the over-withholding. (ii) If a deficiency is discovered, the employer shall notify the city and the employee or former employee, who shall pay the city the additional tax due in his annual return.



MCL 141.660 Tax withheld; payment by employer; return; electronic funds transfer. Sec. 60. (1) Except as provided in subsection (2), an employer shall file a return, furnished by or obtainable on request from the city, and pay to the city the full amount of the tax withheld on or before the last day of the month following the close of each calendar quarter.

(2) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, an employer shall file a return and pay the tax withheld for each calendar month on or before the fifteenth day of the month following the close of each calendar month to the department by means of an electronic funds transfer method approved by the state commissioner of revenue. (Amended by Act 478 of 1996, effective Jan. 1, 1997) MCL 141.760 Alternate Section 60. Sec. 60. (1) Except as provided in subsection (2), an employer shall file a return, furnished by or obtainable on request from the city, and pay to the city the full amount of the tax withheld on or before the last day of the month following the close of each calendar quarter, except that if during any calendar month other than the last month of a calendar quarter the amount withheld exceeds $100.00, the employer shall deposit the amount withheld with the city treasurer before the end of the next calendar month. (2) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, and employer shall file a return and pay the tax withheld for each calendar month on or before the fifteenth day of the month following the close of each calendar month to the department by means of an electronic funds transfer method approved by the state commissioner of revenue. (Amended by Act 478 of 1996, effective Jan. 1, 1997) 141.661 Tax withheld; employer's reconciliation of quarterly returns; deficiency; refund; information return; cessation of business. Sec. 61. (1) An employer shall file with the city or the department a reconciliation of quarterly returns on or before the last day of February following each calendar year in which the employer has withheld from an employee's compensation. A deficiency is due when the reconciliation is filed. If the employer made quarterly payments in excess of the amount withheld from an employee's compensation, the city or the department upon proper verification shall refund the excess to the employer.

(2) In addition to the reconciliation, the employer shall file with the city or the department an information return for each employee from whom the city income tax has been withheld and each employee subject to withholding under this ordinance, setting forth his or her name, address, and social security number, the total amount of compensation paid him or her during the year, and the amount of city income tax withheld. The information return shall be on a copy of the federal W-2 form or on a form furnished or approved by the city or the department. A copy of the information return shall be furnished to the employee.

(3) Except as provided in subsection (4), if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the city by the date the final withholding return and payment are due.



(4) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the department within 30 days after the employer goes out of business or ceases to be an employer.

(Amended by Act 478 of 1996, effective Jan. 1, 1997)

MCL 141.761 Alternate Section 61. Sec. 61. (1) An employer shall file with the city or department a reconciliation of quarterly returns on or before the last day of February following each calendar year in which the employer has withheld from an employee's compensation. A deficiency is due when the reconciliation is filed. If the employer made monthly or quarterly or both, payments in excess of the amount withheld from an employee's compensation, the city or the department upon proper verification shall refund the excess to the employer. (2) In addition to the reconciliation the employer shall file with the city or the department an information return for each employee from whom the city income tax has been withheld and each employee subject to withholding under this ordinance, setting forth his or her name, address, and social security number, the total amount of compensation paid him or her during the year, and the amount of city income tax withheld. The information return shall be on a copy of the federal W-2 form or on a form furnished or approved by the city or the department. A copy of the information return shall be furnished to the employee. (3) Except as provided in subsection (4), if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the city by the date the final withholding return and payment are due. (4) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the department within 30 days after the employer goes out of business or ceases to be an employer. (Amended by Act 478 of 1996, effective Jan. 1, 1997)



2016 Withholding Tax Common Form Updates, Changes and Corrections to

Appendices, Forms, Schedules and Worksheets

1. 2016 Employer’s Withholding Tax Forms and Instructions Booklet. Revised booklet by: rolling due dates; updating appendix references; updating interest rates; and updating penalty rates. (Revised 09/14/2015)

2. 2016 Appendices. Updated and reordered appendices; (revised 09/04/2015)

APPENDIX NUMBER

2016 APPENDIX NAME

2015 APPENDIX NAME

Appendix A Cities Accepting Common Form Withholding Tax Returns, Exemption Amounts and Tax Rates for Tax Year 2016

Withholding Deposit Requirements (Appendix C for 2016)

Appendix B Personal Exemptions Allowed Exemption Amounts and Tax Rates for Tax Year 2015 (Appendix A for 2016)

Appendix C Withholding Deposit Requirements Personal Exemptions Allowed for 2015 (Appendix B for 2016)

Appendix D Authorized City Name Abbreviations to Use for Completing Form W-2, Box 20, Locality Name and Related RS Record Data for EFW2 Transmittals

Approved City Name Abbreviations to Use for Completing Form W-2, Box 20, Locality Name (Appendix D for 2016)

Appendix E Three Character City Name Abbreviation Mailing Addresses for Mailing Returns to Cities Accepting the Withholding Common Form (Appendix G for 2016)

Appendix F Cities Accepting ACH Debit or Credit Withholding Deposits in lieu of Paper Returns; and Cities Accepting Forms W-2 Using Common Form CD-ROM format

Withholding Tax Contacts for Michigan Cities Levying a City Income Tax (Appendix H for 2016)

Appendix G Mailing Addresses for Mailing Returns to Cities Accepting the Withholding Tax Common Form

OCR Scan Line Specifications for Withholding Tax Return Forms, CF-501, CF-941 or CF-W-3 (Appendix I for 2016)

Appendix H Withholding Tax Contacts for Michigan Cities Levying a City Income Tax

Three Character City Name Abbreviation (Appendix E for 2016)

Appendix I OCR Scan Line Specifications for Withholding Tax Return Forms, CF-501, CF-941 or CF-W-3 PAYMENT

Tax ID Check Digit Specifications (Appendix J for 2016)

Appendix J Tax ID Check Digit Specifications Cities Accepting ACH Debit or Credit Withholding Deposits in lieu of Paper Returns; and Cities Accepting Forms W-2 Using Common Form CD-ROM format (Appendix F for 2016)

Appendix K Specifications for Employer Electronic Media Filing of Local (City) Forms W-2

Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance ((MCL 141.601 et seq.) and the Regulations Adopted by Most Michigan Cities (Appendix L for 2016)

Appendix L Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance ((MCL 141.601 et seq.) and the Regulations Adopted by Most Michigan Cities

3. Appendix A, Cities Accepting Common Form Withholding Tax Returns, Exemption Amounts and Tax Rates for Tax Year 2016. Updated for cities accepting and not accepting returns prepared using the withholding tax common form format. (Revised 09/14/2015)



4. Appendix B, Personal Exemptions Allowed. Updated to indicate cities not accepting returns prepared using the withholding tax common form format. (Revised 09/14/2015)

5. Appendix C Withholding Deposit Requirements. Updated to indicate cities accepting and not accepting returns

prepared using the withholding tax common form format. (Revised 09/29/2015)

6. Appendix D, Authorized City Name Abbreviations for Use Completing Form W-2, Box 20 and Related RS Record Data for EFW2 Transmittals. Updated by adding a column of authorized abbreviations for EFW2, RS Record, data locations 298 – 307 and to indicate cities not accepting returns prepared using the withholding tax common form format. (Revised 09/14/2015)

7. Appendix E, Three Character City Name Abbreviation. Updated to indicate cities accepting and not accepting returns

prepared using the withholding tax common form format. (Revised 09/14/2015)

8. Appendix F, Updated to indicate cities accepting and not accepting returns prepared using the withholding tax common form format. (Revised 09/29/2015)

9. Appendix G, Mailing Addresses for Mailing Returns to Cities Accepting the Withholding Tax Common Form. (Revised

09/14/2015)

10. Appendix H, Withholding Tax Contacts for Michigan Cities Levying a City Income Tax. Updated to indicate cities accepting and not accepting returns prepared using the withholding tax common form format. (Revised 09/04/2015)

11. Appendix K, Specifications for Employer Electronic Media Filing of Local (City) Forms W-2. Appendix K was added for

2016. (Revised 10/02/2015)

12. Form CF-SS-4, Employer’s Withholding Registration. Total revision of Form CF-SS-4 and added Instructions for Form CF-SS-4. (Revised 10/05/2015)

13. Form CF-2678, Employer/Payor Appointment of agent. New Form CF-2678 (Revised 0928/2015) and Instructions for

Form CF-2678. (Revised 10/05/2015)

14. Form CF-8655, Reporting Agent. New Form CF-8655 (Revised 0928/2015) and Instructions for Form CF-8655. (Revised 09/29/2015)

15. Withholding Tax Guide. (Revised 09/29/2015)

16. Withholding Tax Forms and Instructions Booklet. Corrected name of Form 941 for all quarters to be Employers

Quarterly Return of Income Tax Withheld. (Revised 09/29/2015)

17. Appendix K, Specifications for Employer Electronic Media Filing of Local (City) Forms W-2 was revised to correct the EFW2 filing specifications for locality data on Form W-2, Box 20 from positions 298 – 307 not 289-307. (Revised 10/02/2015)

18. Form CF-W-3, Employers Annual Reconciliation of Income Tax Withheld. Revised Form CF-W-3. (Revised

10/15/2015)

19. Form CF-W-3S, Supplement to Employers Annual Reconciliation of Income Tax Withheld. Revised Form CF-W-3. (Revised 10/15/2015)

20. Appendix K, Specifications for Employer Electronic Media Filing of Local (City) Forms W-2. Guidance was added to

clarify the data to be inserted in the RS Record Positions 5-9. (Revised 10/28/2015)

21. All Appendices. Revised appendices to reflect that the City of Albion will accept the withholding common form. (Revised 11/3/2015)

22. Appendix F, Cities Accepting ACH Debit or Credit Withholding Deposits. City of Ionia will not accept ACH Credit or

Debit Payments of withholding. (Revised 11/3/2015)

23. Appendix H, Withholding Tax Contacts for Michigan Cities Levying a City Income Tax. Updated appendix to add and update contact information for withholding tax. (Revised 11/16/2015)



24. Form CF-SS-4, Employer’s Withholding Registration. Updated form: changed Part II, General Information, to remove contact information form section and to renumber lines; Added a new Part VI, Contact Information; and renumbered the old Part VI, Signature Information, to Part VII, (Revised 11/19/2015)

25. Instructions for Form CF-SS-4, Employers Withholding Registration. Updated instructions for Part II; In Part III

corrected line number from Lines 1 – 5 to lines 1 – 6; added instructions for Part IV, Type of Ownership; added instructions for Part VI, Contact Information; and renumbered the old Part VI, Signature Information, to Part VII. (Revised 11/19/2015)

26. Form CF-W-3, Employer’s Reconciliation of Income Tax Withheld. Corrected line reference above signature area

perjury statement from line 11 to line 12, and reformatted lines around signature area to make them all black. (Revised 11/20/2015)



FINAL VERSION PUBLISHED ON NOVEMBER 20, 2015...2016 WITHHOLDING TAX COMMON FORM SPECIFICATIONS PACKET FINAL VERSION PUBLISHED ON NOVEMBER 20, 2015 This document contains the final

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