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Tax Check Off - End ALZ
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Tax Form 4642

Michigan taxpayers can quickly and easily checkoff their support for the Alzheimer’s Association vision of a world without Alzheimer’s.

When preparing your 2015 Michigan income taxes, complete Tax Form 4642 - 2015 Michigan Voluntary Contributions Schedule.

Donate $5, $10 or more directly from your Michigan Income Tax return to the Alzheimer’s Association.

If you are receiving a refund, this donation will be taken directly from your refund.

If you are not receiving a refund, this donation will increase your tax due.

Contact Lindsay Brieschke, for questions.

Frequently Asked Questions

Since I am making this donation in 2016, does that mean I can apply it to my 2016 income tax return?

No, your donation will be considered a gift from the 2015 tax year.

Where can I get Tax Form 4642?

Click on this link to download the form.

How do I make a donation if I am doing an electronic form or using tax software?

You will be able to fill out Tax Form 4642 to give a Voluntary Charitable Contribution toward the end of your electronic return. Please use the help options to locate this feature if it doesn’t come up automatically.


If I want to submit my taxes on a paper form, what form should I use to make my donation?

The form will be available soon. 
Then, you can submit Tax Form 4642 MICHIGAN Voluntary Contributions Schedule.


Is there a minimum or maximum amount that I can donate?

Yes, the minimum amount is $5. There is not a maximum amount.


Will I receive a receipt for my donation?

No, you will not receive a separate receipt. You should keep a copy of your tax forms as a receipt for your reference.


Will the Alzheimer’s Association know that I gave a donation?

All donations will be submitted through the Michigan Department of Treasury, and for privacy reasons, the Alzheimer’s Association will not be provided the names of who gave donations.


If I have more questions, who should I contact for answers?

Please contact Lindsay Brieschke, Director of Public Policy or




Alzheimer's Association

Our vision is a world without Alzheimer's
Formed in 1980, the Alzheimer's Association is the world's leading voluntary health organization in Alzheimer's care, support and research.