Michigan Department of Treasury (Rev. 02-17), Page 1 of 2
MICHIGAN Amended Income Tax Return MI-1040X-12
Issued under authority of Public Act 281 of 1967, as amended. Type or print in blue or black ink.
NOTE: If you are amending for tax year 2011 or prior, you must use Form MI-1040X.
1. ENTER TAX YEAR you are amending (YYYY):
2. Filer’s First Name M.I. Last Name
3. Filer’s Full Social Security No. (Example: 123-45-6789)
If a Joint Return, Spouse’s First Name M.I. Last Name
4. Spouse’s Full Social Security No. (Example: 123-45-6789)
Home Address (Number, Street, or P.O. Box)
City or Town State ZIP Code
Married Married
FILING STATUS
Single
Filing Jointly Filing Separately *
* If married ling separately, complete line 4 and enter
spouse’s full name below:
5. On Original Return ................ .....................
6. On This Return ................ .....................
INCOME, ADDITIONS AND DEDUCTIONS A. On Original Return B. Net Change C. Correct Amount
To avoid processing delays, attach all supporting documentation for your adjustments.
7. Adjusted gross income. Explain changes on line 39 ........................ 7.
8. Additions to adjusted gross income ..................................................... 8.
9.
Total income. Add lines 7 and 8 .........................................................
9.
10.
Subtractions from adjusted gross income ...........................................
10.
11. Balance. Subtract line 10 from line 9 .................................................. 11.
12. Multiply number of exemptions by applicable amount (see instructions)... 12.
13. Taxable income. Subtract line 12 from line 11
................................... 13.
14. Tax. Multiply line 13 by tax rate (see instructions) ............................... 14.
NONREFUNDABLE CREDITS
15.
Credit for Income Tax Imposed by Government Units Outside Michigan
15.
16. Historic Preservation Tax Credit (nonrefundable, attach Form 3581) 16.
17. Small Business Investment Tax Credit (attach applicable certicate) 17.
18. Total nonrefundable credits. Add lines 15 through 17
......................... 18.
19. Subtract line 18 from line 14. If line 18 is more than line 14, enter “0” ........ 19.
20. Voluntary Contributions (see instructions) ........................................... 20.
21. Use tax due (see instructions) ............................................................. 21.
22. Add lines 19, 20 and 21 ....................................................................... 22.
REFUNDABLE CREDITS AND PAYMENTS
23. Property Tax Credit (attach MI-1040CR or MI-1040CR-2) .................. 23.
24. Farmland Preservation Tax Credit (attach MI-1040CR-5) .................. 24.
25. Michigan Earned Income Tax Credit (attach copy of federal return) 25.
26. Historic Preservation Tax Credit (refundable, attach Form 3581) ...... 26.
27. Michigan tax withheld (attach Schedule W) ....................................... 27.
28. Estimated tax, extension payments and credit forward ....................... 28.
29. Amount paid with original return, plus additional tax paid after ling (do not include interest or penalty) ... 29. 00
30. Total refundable credits and payments. Add lines 23 through 29 of column C ............................................ 30. 00
REFUND OR BALANCE DUE
31. Overpayment, if any, on original return (see instructions) ........................................................................... 31. 00
32. Subtract line 31 from line 30 (if negative, see instructions.) ........................................................................ 32. 00
33. If line 22, column C, is greater than line 32, enter BALANCE DUE
Include interest and penalty (if applicable, see instructions)
....... 33.
00
34. If line 22, column C, is less than line 32, enter REFUND to be received .................................................... 34. 00
+
Continue on page 2. This form cannot be
0000 2017 10 01 27 4 processed if page 2 is not completed and attached.
Reset Form
MI-1040X-12, Page 2 of 2
Filer’s Full Social Security Number
*Enter dates of Michigan residency for tax year being amended.
RESIDENCY STATUS
Enter dates as MM-DD-YYYY (Example: 04-15-2017).
Resident
Nonresident Part-Year Resident *
35. On Original Return.......... ......................... ............................. ................... FROM TO
36. On This Return ............... ......................... ............................. ................... FROM TO
EXEMPTIONS
37. Complete only if changing the number of exemptions. Enter a number for all that apply in the appropriate box (see instructions).
Enter the number of exemptions claimed: On Your Original Return On This Return
a. Number of federal exemptions.
.................................. a.
...................................... a.
b. Deaf, blind or disabled * ............................................. b.
...................................... b.
c. Number of qualied disabled veterans. ...................... c.
...................................... c.
*Applies to people who are hemiplegic, paraplegic, quadriplegic or classied as totally and permanently disabled under Social Security guidelines.
38.
List below all your dependents and answer all questions for each dependent (E-H answer “Yes” or “No”).
Attach separate sheet if necessary.
A B C D E F G H
Did the Was this
Did the dependent Did you provide dependent live dependent
le a federal return more than half the with you more claimed on
and claim exemption dependent’s than 6 months your original
Name Full Social Security Number Relationship Age for self? support? during the year? return?
EXPLANATION OF CHANGES
39. Explain change in number of dependents and changes to income, deductions and credits. Show computations in detail and
attach applicable schedules and supporting documentation if necessary (see instructions). If an explanation is not provided, the
processing of your return may be delayed or your return may be denied.
Taxpayer Certication. I declare under penalty of perjury that the information in this
Preparer Certication. I declare under penalty of perjury that
return and attachments is true and complete to the best of my knowledge.
this return is based on all information of which I have any knowledge.
Filer’s Signature Date Preparer’s PTIN, FEIN or SSN
Preparer’s Name (print or type)
Spouse’s Signature Date
Preparer’s Business Name, Address and Telephone Number
By checking this box, I authorize Treasury to discuss my return with my
preparer.
Refund, credit, or zero returns. Mail your return to: Michigan Department of Treasury, Lansing, MI 48956
Pay amount on line 33. Mail your check and return to: Michigan Department of Treasury, Lansing, MI 48929
Make check payable to “State of Michigan.” Print last four digits of your Social Security number, the tax year being amended and
“MI-1040X-12” on the front of your check. If paying on behalf of another taxpayer, write the ler’s name and the last four digits of the lers
Social Security number on the check. Do not staple your check to the return. Keep a copy of your return and all supporting schedules for six
years from the date led or the due date, whichever is later.
+ 0000 2017 10 02 27 2
MI-1040X-12, Page 3
Instructions for Form MI-1040X-12
Amended Michigan Income Tax Return
General Instructions
Rounding Dollar Amounts
Round down all amounts less than 50 cents. Round up all
Use this form to correct income tax returns, credit claims and
amounts of 50 through 99 cents. Do not enter cents.
schedules for tax years 2012 and after. If you are amending for
tax year 2011 or prior, you must use Form MI-1040X. Visit
Line-by-Line Instructions
www.michigan.gov/taxes to locate tax forms.
Lines not listed are explained on the form.
To Amend Credit Claims
Line 1: Enter the tax year you are amending (calendar year
If amending any of the following credit claims, le Form
or scal year). Your return cannot be processed without this
MI‑1040X‑12 and attach the document indicated:
information.
• MichiganHistoricPreservationTaxCredit
Lines 7 through 28: Enter an explanation of changes to these
(Attach a corrected Form 3581.)
lines on line 39. See special instructions for amending use tax on
• Small Business Investment Tax Credit (Attach a Michigan
line 21. Attach copies of corrected or new schedules.
Strategic Fund certicate.)
Column A: Enter the amounts shown on your original return or
If you are amending the following credits and have no
as adjusted due to an examination of your original return.
adjustments to Form MI-1040 write “Amended” on the top of the
Column C: Report the corrected totals after taking into account
corrected credit form and do not le Form MI-1040X-12:
the amounts of the increases or decreases shown in column B.
• FarmlandPreservationTaxCreditClaim (Attach a corrected
MI-1040CR-5 and Schedule CR-5 to a corrected MI-1040 and
If there are no changes, enter the amount reported in column A.
write “Amended” at the top of the form.)
Line 7: If you are correcting Adjusted Gross Income (AGI) due
• MichiganHomesteadPropertyTaxCreditClaim (MI-1040CR)
to the amount of wages or other employee compensation, attach
• MichiganHomesteadPropertyTaxCreditClaimforVeterans
Schedule W. If you are correcting AGI based on an amended
andBlindPeople (MI-1040CR-2)
federal return, provide a copy of the amended federal return and
Important note for Michigan Home Heating Credit Claim
supporting schedules.
(MI-1040CR-7) lers. If amending Form MI-1040CR-7, le an
Line 12: Enter the exemption allowance based on the number of
MI-1040CR-7 for the appropriate year and write “Amended” at
exemptions claimed on line 37.
the top. An amended claim requesting an additional refund will
not be accepted after September 30 following the year of the
Michigan
Personal Special Disabled
claim.
Year
Exemption Exemptions Veteran
Michigan and Federal Schedule Changes
2014 $ 3,950 $ 2,500 $ 300
To avoid processing delays, if the change on your income tax
2015 $ 4,000 $ 2,500 $ 400
return is the result of a change to a schedule, attach a copy of the
2016 $ 4,000 $ 2,600 $ 400
corrected schedule to Form MI-1040X-12. This applies to federal
2017 $ 4,000 $ 2,600 $ 400
schedules as well as Michigan schedules.
Filers who can be claimed as a dependent on someone else’s
Income and Deductions
return follow special rules. Refer to the instructions for the tax
If you have questions about what income is taxable or
year being amended.
what is deductible, see the instructions for Form MI-1040
(and related schedules and forms) for the tax year you are
Line 14: Your taxable income must be multiplied by the tax rate
amending. If you need forms or assistance, visit our Web site at
in effect for the year you are amending.
www.michigan.gov/taxes.
Year Tax Rate
When to File
2014 4.25%
File Form MI-1040X-12 only after your original return or claim
2015 4.25%
has been led and completed processing. If you are claiming a
refund on your amended return, you must le it within four years
2016 4.25%
of the due date of your original return. For example, if you wish
2017 4.25%
to amend a 2013 return, Form MI-1040X-12 must be postmarked
Lines 15 through 17: Enter changes in your nonrefundable
by April 17, 2019.
credits. See instructions for the tax year being amended to
Interest and Penalty
determine the amount of your credit. Attach a copy of Form 3581
if you are amending or claiming a new Historic Preservation Tax
If your amended return results in tax due, include interest with
Credit.
your payment. Interest is 1 percent above the prime rate which
is adjusted on July 1 and January 1. For information on interest
Line 20: Amended amounts for voluntary contribution funds or
rates, visit our Web site at www.michigan.gov/taxes. Penalty, if
programs will not be accepted.
applicable, is 10 percent of the tax due (minimum $10).
MI-1040X-12, Page 4
Line 21: Amended use tax amounts will not be accepted on the
On line 37, enter the number of exemptions you claimed on your
MI‑1040X‑12. To amend your use tax, write a letter to Michigan
original return and the number of exemptions you are claiming
Department of Treasury, Business Tax Division, P.O. Box 30427,
on this amended return.
Lansing, MI 48909.
Deaf, Blind or Disabled: You qualify for the deaf exemption if
Lines 23 through 26: Enter changes in your property tax
the primary way you receive messages is through a sense other
credit, farmland preservation tax credit, earned income tax
than hearing, for example: lip reading or sign language. You
credit, and/or historic preservation tax credit. Attach the
qualify for the blind or disabled exemption if you are blind,
appropriate amended claim documentation: MI-1040CR, MI-
hemiplegic, paraplegic, quadriplegic or totally and permanently
1040CR-2, Form 5049, MI-1040CR-5, or Form 3581.
disabled. Blind means your better eye permanently has 20/200
vision or less with corrective lenses, or your peripheral eld of
Line 27: Enter the amended tax withheld by your employer.
vision is 20 degrees or less. Totally and permanently disabled
Attach a corrected Schedule W and provide an explanation
means disabled as dened under Social Security Guidelines 42
to support your claim, including the circumstances that
USC 416. Individuals 66 or older may not claim an exemption as
created the corrected Schedule W if it was corrected.
totally and permanently disabled.
If you are claiming a repayment credit for tax paid on income
Qualified Disabled Veteran: A taxpayer may claim an
reported in a previous year, add the amount of the credit to
exemption in addition to the taxpayers other exemptions if
the Michigan tax withheld. Write the words “Claim of Right/
(a) the taxpayer or spouse is a qualied disabled veteran, or
Repayments” next to line 27. Attach a schedule showing the
(b) a dependent of the taxpayer is a qualied disabled veteran.
computation of the credit, proof of the repayment, and pages 1
To be eligible for the additional exemption an individual must
and 2 of your U.S. Form 1040 and ScheduleA if applicable.
be a veteran of the active military, naval, marine, coast guard,
Line 28: Enter total Michigan estimated tax payments, amounts
or air service who received an honorable or general discharge
credited forward from prior years, and any payment made with a
and has a disability incurred or aggravated in the line of duty as
request for extension.
described in 38 USC 101(16). This additional exemption may
Line 29: Enter the amount paid with your original return and
not be claimed on more than one tax return. See the instructions
any additional tax paid after you led your original return. Do not
for line 12 on page 3.
include interest or penalty payments.
Line 39: Enter the line reference from page 1 for each line
Line 31: Enter the amount of refund you received from your
where a change is reported and give a detailed explanation of
original return. If you received more than one refund from
the reasons for the change. If an explanation is not provided,
the original return, include the total amount of refunds on this
the processing of your return may be delayed or your
line, also include the amount to be credited to next year. Do not
return may be denied. Attach applicable schedules and
include interest received on your refunds.
supporting documentation of the change(s) including, but not
limited to:
Lines 32 and 33: If line 32 is negative, treat it as a positive
amount and add it to the amount on line 22, column C. Enter the
copies of your amended federal return and federal schedules
result on line 33. This is the amount you owe. Include interest
copies of other state return(s)
with your payment. (See “Interest and Penalty” on page 3.)
copies of your W-2(s), 1099(s), and/or Schedule K-1(s)
Make check payable to State of Michiganand write the last
four digits of your Social Security number, the tax year being
copies of your property tax statement(s) and/or lease
amended, and the words MI-1040X-12” on the check.
If paying
agreement(s)
on behalf of another taxpayer, write the lers name and last four
copies of your heat statements
digits of the ler’s Social Security number on the check.
Payment
is not required if the tax due is less than $1. To ensure accurate
When You Are Finished
processing of your return, send one check for each return you are
Refund, Credit or Zero Return. Mail your return to:
amending.
Michigan Department of Treasury
Line 34, REFUND: If line 32 is greater than line 22,
Lansing, MI 48956
column C, subtract line 22, column C, from line 32 and enter this
amount as your refund.
Pay amount on line 33. Mail your check and return to:
Exemptions
Michigan Department of Treasury
Lansing, MI 48929
Line 37: Enter the number of federal exemptions and Michigan
special exemptions claimed on your original return and claimed
Do not staple multiple prior year returns together. However,
on this return.
you can mail multiple prior year returns in the same envelope.
Review the instruction booklet for tax year being amended if you
need denitions or more information.
Complete lines 37 and 38 if you are changing the number of
exemptions or exemption allowance you originally claimed.