Form 1988 - Insurance Company Quarterly Return For Sbt And Retaliatory Tax - Michigan Department Of Treasury - 2004

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Michigan Department of Treasury
1988 (Rev.7-03)
2004 Insurance Company Quarterly Return for SBT and Retaliatory Tax
Issued under authority of P.A. 218 of 1956 and 228 of 1975.
4th QUARTER DUE: January 31, 2005
See instructions for filing guidelines.
Business Name
NAIC Number
Federal Employer ID Number (FEIN) or TR Number
Address (Number and Street)
WRITE PAYMENT
$
4
.00
City, State, ZIP
AMOUNT HERE
Write the federal employer
Mail to: Michigan Treasury
Taxpayer's Signature
number on the check. Make
Dept. 77229
payable to "State of Michigan."
Detroit, MI 48277-0229
Michigan Department of Treasury
1988 (Rev. 7-03)
2004 Insurance Company Quarterly Return for SBT and Retaliatory Tax
Issued under authority of P.A. 218 of 1956 and 228 of 1975.
3rd QUARTER DUE: October 31, 2004
See instructions for filing guidelines.
Business Name
NAIC Number
Federal Employer ID Number (FEIN) or TR Number
Address (Number and Street)
WRITE PAYMENT
$
4
.00
City, State, ZIP
AMOUNT HERE
Mail to: Michigan Treasury
Write the federal employer
Taxpayer's Signature
Dept. 77229
number on the check. Make
Detroit, MI 48277-0229
payable to "State of Michigan."
Michigan Department of Treasury
1988 (Rev. 7-03)
2004 Insurance Company Quarterly Return for SBT and Retaliatory Tax
Issued under authority of P.A. 218 of 1956 and 228 of 1975.
2nd QUARTER DUE: July 31, 2004
See instructions for filing guidelines.
Business Name
NAIC Number
Federal Employer ID Number (FEIN) or TR Number
Address (Number and Street)
WRITE PAYMENT
$
4
.00
City, State, ZIP
AMOUNT HERE
Write the federal employer
Mail to: Michigan Treasury
Taxpayer's Signature
number on the check. Make
Dept. 77229
payable to "State of Michigan."
Detroit, MI 48277-0229
Michigan Department of Treasury
1988 (Rev. 7-03)
2004 Insurance Company Quarterly Return for SBT and Retaliatory Tax
Issued under authority of P.A. 218 of 1956 and 228 of 1975.
1st QUARTER DUE: April 30, 2004
See instructions for filing guidelines.
Business Name
NAIC Number
Federal Employer ID Number (FEIN) or TR Number
Address (Number and Street)
WRITE PAYMENT
$
4
.00
City, State, ZIP
AMOUNT HERE
Mail to: Michigan Treasury
Write the federal employer
Taxpayer's Signature
Dept. 77229
number on the check. Make
Detroit MI, 48277-0229
payable to "State of Michigan."

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