Michigan Department of Treasury 5403 (3-16) Personal Property 2016 Taxable Value for Expired Tax Exemptions Issued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)). See page 3 for instructions. PART 1: EXEMPTION CERTIFICATE INFORMATION Taxpayer Name L'ANSE MANUFACTURING & TECHNOLOGY INC Certificate Type IFT Certificate Number 2009-018 Expiration Date (before extension) 12/30/2015 City/Township Name L'ANSE TOWNSHIP City/Township Revenue Sharing Code 071040 Village Name VILLAGE OF L'ANSE Village Revenue Sharing Code 073020 County Name BARAGA County Revenue Sharing Code 070000 PART 2: ESTIMATED 2016 TAXABLE VALUE 1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278? If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3. Yes ☐ No ☐ 2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00 3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012: if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or if extended PA 328 certificate, see instructions. $ 00 4. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 00 5. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this form. PART 3: CERTIFICATION Printed Name (Assessing Officer) Signature (Assessing Officer) Telephone Number E-mail Address Date
Transcript
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
L'ANSE MANUFACTURING & TECHNOLOGY INCCertificate Type
IFTCertificate Number
2009-018Expiration Date (before extension)
12/30/2015City/Township Name
L'ANSE TOWNSHIPCity/Township Revenue Sharing Code
071040Village Name
VILLAGE OF L'ANSEVillage Revenue Sharing Code
073020County Name
BARAGACounty Revenue Sharing Code
070000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MUNN MANUFACTURINGCertificate Type
IFTCertificate Number
2002-472Expiration Date (before extension)
12/30/2014City/Township Name
IRVING TOWNSHIPCity/Township Revenue Sharing Code
081080Village Name
VILLAGE OF FREEPORTVillage Revenue Sharing Code
083010County Name
BARRYCounty Revenue Sharing Code
080000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MIDWEST DIE CORP.Certificate Type
IFTCertificate Number
2001-224Expiration Date (before extension)
12/30/2013City/Township Name
BARODA TOWNSHIPCity/Township Revenue Sharing Code
111020Village Name
VILLAGE OF BARODAVillage Revenue Sharing Code
113010County Name
BERRIENCounty Revenue Sharing Code
110000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
QME INCCertificate Type
IFTCertificate Number
2002-350Expiration Date (before extension)
12/30/2014City/Township Name
BARODA TOWNSHIPCity/Township Revenue Sharing Code
111020Village Name
VILLAGE OF BARODAVillage Revenue Sharing Code
113010County Name
BERRIENCounty Revenue Sharing Code
110000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF BERRIEN SPRINGSVillage Revenue Sharing Code
113020County Name
BERRIENCounty Revenue Sharing Code
110000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
GRIFFIN TOOL INC.Certificate Type
IFTCertificate Number
2001-207Expiration Date (before extension)
12/30/2013City/Township Name
LINCOLN TOWNSHIPCity/Township Revenue Sharing Code
111120Village Name
VILLAGE OF STEVENSVILLEVillage Revenue Sharing Code
113080County Name
BERRIENCounty Revenue Sharing Code
110000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SPEEDRACK PRODUCTS GROUP LTDCertificate Type
IFTCertificate Number
2002-501Expiration Date (before extension)
12/30/2014City/Township Name
QUINCY TOWNSHIPCity/Township Revenue Sharing Code
121140Village Name
VILLAGE OF QUINCYVillage Revenue Sharing Code
123010County Name
BRANCHCounty Revenue Sharing Code
120000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MCS INDUSTRIES, INCCertificate Type
IFTCertificate Number
2009-086Expiration Date (before extension)
12/30/2014City/Township Name
HOMER TOWNSHIPCity/Township Revenue Sharing Code
131120Village Name
VILLAGE OF HOMERVillage Revenue Sharing Code
133030County Name
CALHOUNCounty Revenue Sharing Code
130000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MILLER BROTHERS MFG CO INCCertificate Type
IFTCertificate Number
2005-605Expiration Date (before extension)
12/30/2015City/Township Name
HOMER TOWNSHIPCity/Township Revenue Sharing Code
131120Village Name
VILLAGE OF HOMERVillage Revenue Sharing Code
133030County Name
CALHOUNCounty Revenue Sharing Code
130000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
JORGENSEN STEEL MACHINING & FABRICATION INCCertificate Type
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
FUTURE MOLD CORPCertificate Type
IFTCertificate Number
2003-240Expiration Date (before extension)
12/30/2015City/Township Name
SURREY TOWNSHIPCity/Township Revenue Sharing Code
181150Village Name
VILLAGE OF FARWELLVillage Revenue Sharing Code
183010County Name
CLARECounty Revenue Sharing Code
180000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
FUTURE MOLD CORPORATIONCertificate Type
IFTCertificate Number
2002-344Expiration Date (before extension)
12/30/2014City/Township Name
SURREY TOWNSHIPCity/Township Revenue Sharing Code
181150Village Name
VILLAGE OF FARWELLVillage Revenue Sharing Code
183010County Name
CLARECounty Revenue Sharing Code
180000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MELLING PRODUCTS CORPORATIONCertificate Type
IFTCertificate Number
2002-342Expiration Date (before extension)
12/30/2014City/Township Name
SURREY TOWNSHIPCity/Township Revenue Sharing Code
181150Village Name
VILLAGE OF FARWELLVillage Revenue Sharing Code
183010County Name
CLARECounty Revenue Sharing Code
180000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ALPHI INC.Certificate Type
IFTCertificate Number
2001-356Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ALPHI MANUFACTURING, LLCCertificate Type
IFTCertificate Number
2003-439Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HILLSDALE TERMINAL & TOOLSCertificate Type
IFTCertificate Number
2007-346Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
JONESVILLE PAPER TUBE CORPCertificate Type
IFTCertificate Number
2003-438Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
JONESVILLE PAPER TUBE CORPORATIONCertificate Type
IFTCertificate Number
2001-301Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
JONESVILLE TOOL & MANUFACTURINGCertificate Type
IFTCertificate Number
2001-372Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
JONESVILLE TOOL & MANUFACTURINGCertificate Type
IFTCertificate Number
2002-263Expiration Date (before extension)
12/30/2014City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
NYLONCRAFTCertificate Type
IFTCertificate Number
2007-494Expiration Date (before extension)
12/30/2014City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SKD JONESVILLECertificate Type
IFTCertificate Number
2001-312Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SKD LP JONESVILLE STAMPINGCertificate Type
IFTCertificate Number
2003-440Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SKD LP JONESVILLE STAMPINGCertificate Type
IFTCertificate Number
2003-441Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF JONESVILLECity/Township Revenue Sharing Code
302015Village Name Village Revenue Sharing Code
County Name
HILLSDALECounty Revenue Sharing Code
300000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
AXIS MACHINING INCCertificate Type
IFTCertificate Number
2002-306Expiration Date (before extension)
12/30/2014City/Township Name
WINSOR TOWNSHIPCity/Township Revenue Sharing Code
321280Village Name
VILLAGE OF PIGEONVillage Revenue Sharing Code
323050County Name
HURONCounty Revenue Sharing Code
320000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
AXIS MACHINING INCCertificate Type
IFTCertificate Number
2003-475Expiration Date (before extension)
12/30/2015City/Township Name
WINSOR TOWNSHIPCity/Township Revenue Sharing Code
321280Village Name
VILLAGE OF PIGEONVillage Revenue Sharing Code
323050County Name
HURONCounty Revenue Sharing Code
320000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HURON CASTING INCCertificate Type
IFTCertificate Number
2002-096Expiration Date (before extension)
12/30/2014City/Township Name
WINSOR TOWNSHIPCity/Township Revenue Sharing Code
321280Village Name
VILLAGE OF PIGEONVillage Revenue Sharing Code
323050County Name
HURONCounty Revenue Sharing Code
320000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HURON CASTING INC.Certificate Type
IFTCertificate Number
1999-152Expiration Date (before extension)
12/30/2013City/Township Name
WINSOR TOWNSHIPCity/Township Revenue Sharing Code
321280Village Name
VILLAGE OF PIGEONVillage Revenue Sharing Code
323050County Name
HURONCounty Revenue Sharing Code
320000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HURON CASTING INC.Certificate Type
IFTCertificate Number
2001-235Expiration Date (before extension)
12/30/2013City/Township Name
WINSOR TOWNSHIPCity/Township Revenue Sharing Code
321280Village Name
VILLAGE OF PIGEONVillage Revenue Sharing Code
323050County Name
HURONCounty Revenue Sharing Code
320000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
AUTOMATED PROCESS EQUIPMENT CORPORATIONCertificate Type
IFTCertificate Number
2011-087Expiration Date (before extension)
12/30/2014City/Township Name
ODESSA TOWNSHIPCity/Township Revenue Sharing Code
341100Village Name
VILLAGE OF LAKE ODESSAVillage Revenue Sharing Code
343030County Name
IONIACounty Revenue Sharing Code
340000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
AUTOMATED PROCESS EQUIPMENT CORPORATIONCertificate Type
IFTCertificate Number
2013-444Expiration Date (before extension)
12/30/2015City/Township Name
ODESSA TOWNSHIPCity/Township Revenue Sharing Code
341100Village Name
VILLAGE OF LAKE ODESSAVillage Revenue Sharing Code
343030County Name
IONIACounty Revenue Sharing Code
340000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
INTEGRITY PRINTINGCertificate Type
IFTCertificate Number
2002-542Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF CLARECity/Township Revenue Sharing Code
372005Village Name Village Revenue Sharing Code
County Name
ISABELLACounty Revenue Sharing Code
370000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
INTEGRITY PRINTINGCertificate Type
IFTCertificate Number
2003-224Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF CLARECity/Township Revenue Sharing Code
372005Village Name Village Revenue Sharing Code
County Name
ISABELLACounty Revenue Sharing Code
370000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MICHIGAN AUTOMOTIVE COMPRESSOR INC.Certificate Type
IFTCertificate Number
2000-145Expiration Date (before extension)
12/30/2013City/Township Name
SANDSTONE CHARTER TOWNSHIPCity/Township Revenue Sharing Code
381140Village Name
VILLAGE OF PARMAVillage Revenue Sharing Code
383060County Name
JACKSONCounty Revenue Sharing Code
380000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MICHIGAN AUTOMOTIVE COMPRESSOR INC.Certificate Type
IFTCertificate Number
2001-346Expiration Date (before extension)
12/30/2014City/Township Name
SANDSTONE CHARTER TOWNSHIPCity/Township Revenue Sharing Code
381140Village Name
VILLAGE OF PARMAVillage Revenue Sharing Code
383060County Name
JACKSONCounty Revenue Sharing Code
380000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF SCHOOLCRAFTVillage Revenue Sharing Code
393040County Name
KALAMAZOOCounty Revenue Sharing Code
390000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF SCHOOLCRAFTVillage Revenue Sharing Code
393040County Name
KALAMAZOOCounty Revenue Sharing Code
390000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF SCHOOLCRAFTVillage Revenue Sharing Code
393040County Name
KALAMAZOOCounty Revenue Sharing Code
390000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
CONTINENTAL IDENTIFICATION PRODUCTSCertificate Type
IFTCertificate Number
2001-442Expiration Date (before extension)
12/30/2013City/Township Name
SPARTA TOWNSHIPCity/Township Revenue Sharing Code
411180Village Name
VILLAGE OF SPARTAVillage Revenue Sharing Code
413050County Name
KENTCounty Revenue Sharing Code
410000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
GENERAL FORMULATIONSCertificate Type
IFTCertificate Number
2001-441Expiration Date (before extension)
12/30/2013City/Township Name
SPARTA TOWNSHIPCity/Township Revenue Sharing Code
411180Village Name
VILLAGE OF SPARTAVillage Revenue Sharing Code
413050County Name
KENTCounty Revenue Sharing Code
410000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SPARTAN GRAPHICS INCCertificate Type
IFTCertificate Number
2002-379Expiration Date (before extension)
12/30/2014City/Township Name
SPARTA TOWNSHIPCity/Township Revenue Sharing Code
411180Village Name
VILLAGE OF SPARTAVillage Revenue Sharing Code
413050County Name
KENTCounty Revenue Sharing Code
410000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SPARTAN GRAPHICS INCCertificate Type
IFTCertificate Number
2003-452Expiration Date (before extension)
12/30/2015City/Township Name
SPARTA TOWNSHIPCity/Township Revenue Sharing Code
411180Village Name
VILLAGE OF SPARTAVillage Revenue Sharing Code
413050County Name
KENTCounty Revenue Sharing Code
410000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
FILLMORE EQUIPMENT INC.Certificate Type
IFTCertificate Number
2002-018Expiration Date (before extension)
12/30/2014City/Township Name
TYRONE TOWNSHIPCity/Township Revenue Sharing Code
411200Village Name
VILLAGE OF KENT CITYVillage Revenue Sharing Code
413030County Name
KENTCounty Revenue Sharing Code
410000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ARISTO-CAST INCCertificate Type
IFTCertificate Number
2003-093Expiration Date (before extension)
12/30/2015City/Township Name
ALMONT TOWNSHIPCity/Township Revenue Sharing Code
441010Village Name
VILLAGE OF ALMONTVillage Revenue Sharing Code
443010County Name
LAPEERCounty Revenue Sharing Code
440000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HARDWOODS OF MICHIGAN INCCertificate Type
IFTCertificate Number
2003-129Expiration Date (before extension)
12/30/2015City/Township Name
CLINTON TOWNSHIPCity/Township Revenue Sharing Code
461040Village Name
VILLAGE OF CLINTONVillage Revenue Sharing Code
463060County Name
LENAWEECounty Revenue Sharing Code
460000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ASAHI THERMOFIL INC.Certificate Type
IFTCertificate Number
2001-051Expiration Date (before extension)
12/30/2013City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ASAHI THERMOFIL, INC.Certificate Type
IFTCertificate Number
2002-029Expiration Date (before extension)
12/30/2014City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
BV CHASSIS SYSTEMSCertificate Type
IFTCertificate Number
2001-327Expiration Date (before extension)
12/30/2013City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
DEDOES INNOVATIVE MANUFACTURING INCCertificate Type
IFTCertificate Number
2004-407Expiration Date (before extension)
12/30/2015City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HATCH STAMPING COCertificate Type
IFTCertificate Number
2003-014Expiration Date (before extension)
12/30/2014City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MS PLASTIC WELDERS INCCertificate Type
IFTCertificate Number
2003-374Expiration Date (before extension)
12/30/2014City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
TRW AUTOMOTIVECertificate Type
IFTCertificate Number
2003-437Expiration Date (before extension)
12/30/2015City/Township Name
HANDY TOWNSHIPCity/Township Revenue Sharing Code
471080Village Name
VILLAGE OF FOWLERVILLEVillage Revenue Sharing Code
473010County Name
LIVINGSTONCounty Revenue Sharing Code
470000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
FORD MOTOR CO. - ROMEO ENGINE PLANTCertificate Type
IFTCertificate Number
2001-197Expiration Date (before extension)
12/30/2015City/Township Name
BRUCE TOWNSHIPCity/Township Revenue Sharing Code
501020Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
FORD MOTOR COMPANYCertificate Type
IFTCertificate Number
1999-341Expiration Date (before extension)
12/30/2013City/Township Name
BRUCE TOWNSHIPCity/Township Revenue Sharing Code
501020Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
KRIEWALL ENTERPRISES INCCertificate Type
IFTCertificate Number
2003-341Expiration Date (before extension)
12/30/2015City/Township Name
BRUCE TOWNSHIPCity/Township Revenue Sharing Code
501020Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MAC-MOLD BASE INC.Certificate Type
IFTCertificate Number
2000-721Expiration Date (before extension)
12/30/2013City/Township Name
BRUCE TOWNSHIPCity/Township Revenue Sharing Code
501020Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SHARP MODEL COMPANYCertificate Type
IFTCertificate Number
2000-720Expiration Date (before extension)
12/30/2013City/Township Name
BRUCE TOWNSHIPCity/Township Revenue Sharing Code
501020Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SHELBY ENTERPRISES INC.Certificate Type
IFTCertificate Number
2001-611Expiration Date (before extension)
12/30/2014City/Township Name
BRUCE TOWNSHIPCity/Township Revenue Sharing Code
501020Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
BASIC METALS, INC.Certificate Type
IFTCertificate Number
2013-092Expiration Date (before extension)
12/30/2014City/Township Name
LENOX TOWNSHIPCity/Township Revenue Sharing Code
501070Village Name
VILLAGE OF NEW HAVENVillage Revenue Sharing Code
503030County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ROMEO MOLD TECHNOLOGIES INC.Certificate Type
IFTCertificate Number
2001-519Expiration Date (before extension)
12/30/2013City/Township Name
WASHINGTON TOWNSHIPCity/Township Revenue Sharing Code
501120Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ROMEO TECHNOLOGIES INC.Certificate Type
IFTCertificate Number
2000-719Expiration Date (before extension)
12/30/2013City/Township Name
WASHINGTON TOWNSHIPCity/Township Revenue Sharing Code
501120Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ROMEO TECHNOLOTIES INCCertificate Type
IFTCertificate Number
2003-182Expiration Date (before extension)
12/30/2015City/Township Name
WASHINGTON TOWNSHIPCity/Township Revenue Sharing Code
501120Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ULTRAFORM INDUSTRIES INCCertificate Type
IFTCertificate Number
2002-302Expiration Date (before extension)
12/30/2014City/Township Name
WASHINGTON TOWNSHIPCity/Township Revenue Sharing Code
501120Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ZAJAC INDUSTRIES INCCertificate Type
IFTCertificate Number
2001-036Expiration Date (before extension)
12/30/2013City/Township Name
WASHINGTON TOWNSHIPCity/Township Revenue Sharing Code
501120Village Name
VILLAGE OF ROMEOVillage Revenue Sharing Code
503040County Name
MACOMBCounty Revenue Sharing Code
500000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
AXIS ENGINEERINGCertificate Type
IFTCertificate Number
2002-141Expiration Date (before extension)
12/30/2014City/Township Name
DUNDEE TOWNSHIPCity/Township Revenue Sharing Code
581040Village Name
VILLAGE OF DUNDEEVillage Revenue Sharing Code
583020County Name
MONROECounty Revenue Sharing Code
580000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
CLEAN TECH INCCertificate Type
IFTCertificate Number
2002-314Expiration Date (before extension)
12/30/2014City/Township Name
DUNDEE TOWNSHIPCity/Township Revenue Sharing Code
581040Village Name
VILLAGE OF DUNDEEVillage Revenue Sharing Code
583020County Name
MONROECounty Revenue Sharing Code
580000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
KRESTEC ENGINEERINGCertificate Type
IFTCertificate Number
2001-590Expiration Date (before extension)
12/30/2014City/Township Name
DUNDEE TOWNSHIPCity/Township Revenue Sharing Code
581040Village Name
VILLAGE OF DUNDEEVillage Revenue Sharing Code
583020County Name
MONROECounty Revenue Sharing Code
580000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
CAMPBELL INDUSTRIAL FORCE / R&P INCCertificate Type
IFTCertificate Number
2006-393Expiration Date (before extension)
12/30/2014City/Township Name
HOME TOWNSHIPCity/Township Revenue Sharing Code
591120Village Name
VILLAGE OF EDMOREVillage Revenue Sharing Code
593010County Name
MONTCALMCounty Revenue Sharing Code
590000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
PACKAGING CORPORATION OF AMERICACertificate Type
IFTCertificate Number
2003-511Expiration Date (before extension)
12/30/2013City/Township Name
HOME TOWNSHIPCity/Township Revenue Sharing Code
591120Village Name
VILLAGE OF EDMOREVillage Revenue Sharing Code
593010County Name
MONTCALMCounty Revenue Sharing Code
590000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
PACKAGING CORPORATION OF AMERICACertificate Type
IFTCertificate Number
2005-019Expiration Date (before extension)
12/30/2015City/Township Name
HOME TOWNSHIPCity/Township Revenue Sharing Code
591120Village Name
VILLAGE OF EDMOREVillage Revenue Sharing Code
593010County Name
MONTCALMCounty Revenue Sharing Code
590000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
ABB INCCertificate Type
IFTCertificate Number
2007-602Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF AUBURN HILLSCity/Township Revenue Sharing Code
632005Village Name Village Revenue Sharing Code
County Name
OAKLANDCounty Revenue Sharing Code
630000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
GREAT LAKES WOOD PELLETS LLCCertificate Type
IFTCertificate Number
2009-369Expiration Date (before extension)
12/30/2014City/Township Name
MARION TOWNSHIPCity/Township Revenue Sharing Code
671090Village Name
VILLAGE OF MARIONVillage Revenue Sharing Code
673030County Name
OSCEOLACounty Revenue Sharing Code
670000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF CONSTANTINEVillage Revenue Sharing Code
753040County Name
SAINT JOSEPHCounty Revenue Sharing Code
750000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF CONSTANTINEVillage Revenue Sharing Code
753040County Name
SAINT JOSEPHCounty Revenue Sharing Code
750000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
IAC MENDON, LLCCertificate Type
IFTCertificate Number
2002-393Expiration Date (before extension)
12/30/2014City/Township Name
MENDON TOWNSHIPCity/Township Revenue Sharing Code
751100Village Name
VILLAGE OF MENDONVillage Revenue Sharing Code
753050County Name
SAINT JOSEPHCounty Revenue Sharing Code
750000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
VILLAGE OF CENTREVILLEVillage Revenue Sharing Code
753020County Name
SAINT JOSEPHCounty Revenue Sharing Code
750000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
FASTENER ADVANCE PRODUCTSCertificate Type
IFTCertificate Number
2010-004Expiration Date (before extension)
12/30/2014City/Township Name
MANCHESTER TOWNSHIPCity/Township Revenue Sharing Code
811090Village Name
VILLAGE OF MANCHESTERVillage Revenue Sharing Code
813030County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
PIERCE FASTNER PRODUCTSCertificate Type
IFTCertificate Number
2006-703Expiration Date (before extension)
12/30/2015City/Township Name
MANCHESTER TOWNSHIPCity/Township Revenue Sharing Code
811090Village Name
VILLAGE OF MANCHESTERVillage Revenue Sharing Code
813030County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
3515 BROAD ST. LLCCertificate Type
IFTCertificate Number
2013-104Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF DEXTERCity/Township Revenue Sharing Code
811140Village Name Village Revenue Sharing Code
County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
BERRY & ASSOCIATES INCCertificate Type
IFTCertificate Number
2009-276Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF DEXTERCity/Township Revenue Sharing Code
811140Village Name Village Revenue Sharing Code
County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
DEXTER AUTOMATIC PRODUCTS COCertificate Type
IFTCertificate Number
2007-020Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF DEXTERCity/Township Revenue Sharing Code
811140Village Name Village Revenue Sharing Code
County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
MICHIGAN CRITICAL CARE CONSULTANTS, INC.Certificate Type
IFTCertificate Number
2014-450Expiration Date (before extension)
12/30/2015City/Township Name
CITY OF DEXTERCity/Township Revenue Sharing Code
811140Village Name Village Revenue Sharing Code
County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
HARDWOOD SOLUTIONS INCCertificate Type
IFTCertificate Number
2006-213Expiration Date (before extension)
12/30/2013City/Township Name
CITY OF CHELSEACity/Township Revenue Sharing Code
812015Village Name Village Revenue Sharing Code
County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
and enter amount here and on Part 2, line 2. $
Michigan Department of Treasury5403 (3-16)
Personal Property 2016 Taxable Value for Expired Tax ExemptionsIssued under the authority of Public Act 86 of 2014 (MCL 123.1353(6)).
See page 3 for instructions.
PART 1: EXEMPTION CERTIFICATE INFORMATIONTaxpayer Name
SHERIDAN BOOKS INCCertificate Type
IFTCertificate Number
2004-599Expiration Date (before extension)
12/30/2014City/Township Name
CITY OF CHELSEACity/Township Revenue Sharing Code
812015Village Name Village Revenue Sharing Code
County Name
WASHTENAWCounty Revenue Sharing Code
810000PART 2: ESTIMATED 2016 TAXABLE VALUE
1. Is the personal property that is under (or formerly under) the exemption certificate identified in Part 1 of this form, Eligible Manufacturing Personal Property (EMPP) AND did the taxpayer report its fair market value on Part 3 of the 2016 Affidavit and Statement for Eligible Manufacturing Personal Property and Essential Services Assessment, Form 5278?
If yes, complete the rest of the form. If no, skip line 2 through line 5 and complete Part 3.
Yes ☐ No ☐
2. For EMPP formerly under the exemption certificate identified in Part 1 of this form and first placed in service before 2006, enter the amount from line 4 or line 8 of the optional worksheet on page 2 or enter the 2016 estimated taxable value from information provided by the taxpayer. $ 00
3. For EMPP under the exemption certificate identified in Part 1 of this form and first placed in service in 2006 – 2012:
if extended IFT certificate, enter the assessed value from Part 2 of the 2016 Form 5278; or
if extended PA 328 certificate, see instructions. $ 004. Estimated 2016 Taxable Value (sum of lines 2 and 3) $ 005. Is EMPP located in one or more tax increment finance authority (TIF) districts? If yes, list the name of each TIF. If no, complete Part 3 of this
form.
PART 3: CERTIFICATIONPrinted Name (Assessing Officer) Signature (Assessing Officer)
Telephone Number E-mail Address Date
If you have any questions, call 517-373-2697.
Return a completed and signed form to the Michigan Department of Treasury by April 30, 2016. Forms can be e-mailed to [email protected], faxed to 517-335-3298, or mailed to:
Michigan Department of TreasuryOffice of Revenue and Tax AnalysisPO Box 30722Lansing MI 48909
In addition, send a copy of the completed form to the county equalization director and each TIF identified in Part 2, line 5.
Optional Worksheet for Completing Part 2, Line 2 See pages 3 and 4 for instructions.
1. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the acquisition cost from the 2015 Personal Property Statement, Form 632. $
2. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, enter the true cash value from the 2015 Form 632. $
3. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, compute and enter the estimated 2016 true cash value using the acquisition costs reported on the 2015 Form 632 and using 2016 multipliers. See instructions. $
4. For EMPP that was formerly under the IFT certificate identified in Part 1 of this form and was first placed in service before 2006, if the taxpayer reported the fair market value of that specific EMPP on Part 3 of 2016 Form 5278, complete lines 5-8. Otherwise, multiply line 3 of this worksheet by 50% (0.50) and enter the amount here and on Part 2, line 2. $
5. Divide line 3 by line 1. %6. For EMPP that was formerly under the IFT exemption certificate identified in Part 1 of this form and that
was first placed in service before 2006, enter the fair market value from Part 3 of 2016 the Form 5278. $7. Multiply line 6 by line 5. $8. Estimated 2016 Taxable Value for EMPP placed in service prior to 2006: Multiply line 7 by 50% (0.50)
