Michigan 3683 Form PDF Details

Do you have a large purchase coming up but don't know what forms to fill out? If you're in Michigan, the form you need is called Form 3683. Whether it's for an expensive car purchase or office equipment, correctly using the 3683 form will help ensure that all of your transactions details are properly taken care of and that both parties understand who pays how much. This post explains what Form 3683 is, how it works and how to use it properly. Read on so that your next big financial transaction in Michigan goes smoothly!

QuestionAnswer
Form NameMichigan 3683 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesmichigan 3683, mi form 3683, fillable state of michigan tax forms, mi service col

Form Preview Example

Michigan Department of Treasury P.O. Box 30778
Lansing, MI 48909-8278

Michigan Department of Treasury

36

3683 (Rev. 8-09)

Payroll Service Provider Combined Power of Attorney Authorization and Corporate Officer Liability (COL) Certificate for Businesses

Issued under authority of the Revenue Act, P.A. 122 of 1941, as amended. Filing is voluntary.

Complete this form if you wish to appoint someone to represent your business to the State of Michigan for withholding tax matters.

Taxpayer Name

Address (Street or RR#)

City, State, ZIP Code

Contact Person

Payroll Service Name

Address (Street or RR#)

City, State, ZIP Code

Contact Person

Account No./Federal Employer ID No. (FEIN)

Telephone Number

Telephone Number

Effective _________________________ (mo/day/yr), the above-named payroll service provider/individual is authorized to

represent my business and receive information in reference to all Treasury income tax withholding matters until I notify the Michigan Department of Treasury in writing that this Power of Attorney is revoked.

Taxpayer's Power of Attorney Authorization

Must be signed by an authorized representative of the business. I certify that I have the authority to execute this Power of Attorney.

Signature

Date

Type or Print Name

Title

Please be aware of officer, member or partner liability as provided in Michigan Compiled Laws 205.27a(5):

"If a corporation, limited liability company, limited liability partnership, partnership, or limited partnership liable for taxes administered under this act fails for any reason to file the required returns or pay the tax due, any of its officers, members, managers, or partners who the department determines, based on either an audit or an investigation, have control or supervision of, or responsibility for, making the returns or payments is personally liable for the failure......."

CERTIFICATION

Corporations, partnerships, LLP's or LLC's must complete this section before this form can be processed. This officer, member or partner certification must be resubmitted when there is a change in the individual responsible for filing and/or paying Michigan taxes.

Signature of Corporate Officer, Partner, or Member responsible for reporting and/or paying Michigan taxes

Date

Type or Print

Title

If you have any questions, please contact the Michigan Department of Treasury at (517) 636-4660. You may fax this form to (517) 636-4520, or mail to:

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Learn how to fill out form 3683 michigan portion 1

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Title, Date, and Type or Print inside form 3683 michigan

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