Fillable Form 2021: L-4175 2021 Personal Property Statement (As (Michigan)

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Form 2021: L-4175 2021 Personal Property Statement (As (Michigan)

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This form must be completed
and returned to the assessor by
February 22, 2021.
Michigan Department of Treasury
632 (Rev. 07-20)
Issued under authority of Public Act 206 of 1893.
Approved by the State Tax Commission August 18, 2020.
Pa
rcel No.
2021 Personal Property Statement (As of 12-31-20)
L-4175
2021
Location(s) of Personal Property Reported on This Statement.
LIST ALL LOCATIONS. Attach additional sheets if necessary.
TO: (Name and Address of Taxpayer)
FROM: (Name and Address of Assessor)
Legal Name of Taxpayer
Address Where Personal Property Records are Kept
Assumed Names Used by Legal Entity, if any
Name of Person in Charge of Records Taxpayer Telephone No.
Description of Taxpayer's Business Activity and NAICS Code
Preparer's Name, Address, Telephone Number and E-mail address Check One Only:
Sole Proprietorship
P artnership
L imited Liability Co.
C orporation
MI ID# _
Date of Organization Date Business Began at
above location
Names of Owner(s) or Partners
(If sole proprietorship or partnership)
If Sole Proprietorship, Taxpayer's Residential Address
Square Feet
Occupied
NOTICE: DO NOT USE THIS FORM TO CLAIM AN EXEMPTION OF ELIGIBLE MANUFACTURING PERSONAL PROPERTY (EMPP) PURSUANT TO
MCL 211.9m AND MCL 211.9n. To claim an exemption for EMPP, file Form 5278 with the local assessor where the personal property is located
no later than February 22, 2021. Leasing companies are not eligible to file Form 5278 and must complete this form. Pursuant to MCL 211.9o, if
the true cash value of the assessable personal property you or a related party own, lease or possess in this local assessing unit is less than
$80,000, then you do not need to file this form if the property is classified as commercial or industrial personal property and you timely claim
the exemption. Instead, file Form 5076 with the local unit where the property is located no later than February 22, 2021. See the instructions on
Page 5.
SUMMARY AND CERTIFICATION. Complete ALL questions.
1. Have you excluded any exempt "Special Tools" from this statement?
Yes No
If Yes, state total original cost
excluded _________________
2. Have you excluded any air and water pollution control facilities and/or wind or water
energy conversion devices for which an exemption certificate has been issued?
Yes No
If Yes, attach itemized list.
3. Have you, to the best of your knowledge, reported all of your assessable tangible
personal property located in Michigan including fully depreciated and/or expensed
assets, to the appropriate assessment jurisdiction?
Yes No
If No, attach explanation.
4. Did you hold a legal or equitable interest in personal property assessable in this
jurisdiction which you have not reported on this statement (see instructions)?
Yes No
If Yes, attach itemized list.
Grand total from page 2
Grand total from page 3
Grand total from page 4
Total cost of Idle Equipment from Form 2698
Total cost of Personal Property Construction in Progress
Total cost of Cable TV, Utility and Wind Energy Assets from Forms 633, 3589 and 4565
Total cost of cellular site equipment from Form(s) 4452
TOTAL
The undersigned certifies that he/she is an owner, officer and/or the duly authorized
agent for the above named taxpayer and that the above summary, with its supporting
documents, provides a full and true statement of all tangible personal property
owned or held by the taxpayer at the locations listed above on December 31, 2020.
Signature of Certifier
ASSESSOR'S ADJUSTMENT(S)
EXEMPTION(S)
TRUE CASH VALUE
ASSESSED VALUE (50% of TCV)
Assessor Calculations
Date
X .50
Are you a party (as either a landlord or a tenant) to a rental or lease agreement relating
to real property in this jurisdiction?
Have any of your assets been subjected to "rebooking" of costs for accounting
purposes or been purchased used (see instructions)?
Is any of your property "daily rental property," per P.A. 537 of 1998?
Are other businesses operated at your location(s)?
If Yes, complete Section O.
If Yes, attach itemized list.
If Yes, attach Form 3595.
If Yes, attach itemized list.
Yes
No
Yes No
Yes No
Yes No
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Enter zero if appropriate.
9b.
10b.
11b.
12b.
13b.
14b.
15b.
9a.
10a.
11a.
12a.
13a.
14a.
15a.
Reset Form
632, Page 2
INSTRUCTIONS. Read carefully to obtain directions for the allocation of your personal property to Sections A - N.
All Tangible Personal Property in your possession at this location, including fully depreciated and expensed assets, must be reported in one of the
Sections A through N. If you had "Move-Ins" of used property, you must also complete Form 3966, 2021 Taxpayer Report of Personal Property
"Move-Ins" of Used Equipment Occurring During 2020. "Move-Ins" are items of assessable personal property (hereafter referred to as "property") that
were not assessed in this city or township in 2020, including (1) purchases of used property, (2) used property you moved in from a location outside this
city or township, (3) property that was exempt in 2020 (such as exempt Industrial Facilities Tax property), and (4) property that you mistakenly omitted
from your statement in 2020. "Move-Ins" DO NOT include property that has been moved from another location WITHIN this city or township or that was
assessed to another taxpayer within this city or township in 2020 (i.e., property reported by a previous owner or previously leased property reported by
the lessor in 2020). All "Move-Ins" must be reported on Page 2 of this form and on Form 3966. Do not report 2020 acquisitions of new property on Form
3966.
Did you have "move-ins"?
Yes No
SECTION A:
Including Furniture and Fixtures
Assessor
Calculations
2020 .91
2019 .80
2018 .69
2017 .61
2016 .53
2015 .47
2014 .42
2013 .37
2012 .33
2011 .29
2010 .27
2009 .24
2008 .22
2007 .19
2006 .12
Prior .12
TOTALS
A1 A2
SECTION D: Including Office, Electronic,
Video and Testing Equipment
Assessor
Calculations
2020 .84
2019 .64
2018 .55
2017 .49
2016 .44
2015 .41
2014 .38
2013 .35
2012 .33
2011 .31
2010 .29
2009 .28
2008 .26
2007 .25
2006 .17
Prior .17
TOTALS
D1 D2
SECTION B:
Including Machinery and Equipment
Assessor
Calculations
2020 .89
2019 .76
2018 .67
2017 .60
2016 .54
2015 .49
2014 .45
2013 .42
2012 .38
2011 .36
2010 .33
2009 .31
2008 .29
2007 .28
2006 .23
Prior .23
TOTALS
B1 B2
SECTION C:
Including Rental Videotapes and Games
Assessor
Calculations
2020
.76
2019
.53
2018
.29
2017
.05
Prior
.05
TOTALS
C1 C2
SECTION E: Including Consumer
Coin Operated Equipment
Assessor
Calculations
2020 .92
2019 .85
2018 .77
2017 .69
2016 .61
2015 .54
2014 .46
2013 .38
2012 .30
2011 .23
2010 .15
Prior .15
TOTALS
E1 E2
SECTION F:
Including Computer Equipment
Assessor
Calculations
2020
.60
2019
.44
2018
.32
2017
.24
2016
.19
2015
.15
2014
.08
Prior
.08
TOTALS
F1 F2
COST GRAND TOTAL (for page 2)
TAXPAYER: Add totals from cost columns
of Sections A-F (A1-F1). Enter grand total
here and carry to line 9a, page 1.
$
TRUE CASH VALUE GRAND TOTAL (for page 2)
ASSESSOR: Add True Cash Value totals
from Sections A-F (A2-F2). Enter grand
$
total here and carry to line 9b, page 1.
632, Page 3
Parcel No.
L-4175
SECTION G - Other Assessable Personal Property Which You Own
Assessable Tangible Personal Property in your possession that is not entitled to depreciation under Generally Accepted Accounting
Principals (GAAP) (e.g. fine art) or that the assessor has told you to report in this Section or that is otherwise described in the
instructions should be reported under this section. Any Personal Property reported in this Section should NOT be reported elsewhere on
Form 632 (L-4175). See instructions. Attach additional sheets, if necessary.
Description of Property
Acquisition
Cost New
Acquisition
Year
True Cash Value
Assessor's Calculations
Total Acquisition Cost New
G1 G2
SECTION H - Standard Tooling
You must report your standard tooling in this Section. Complete both
columns. Notice that GAAP net book value, as reported in this Section,
must implement accounting "changes in estimate", even if not otherwise
material. Any Personal Property reported in this Section should NOT be
reported elsewhere on Form 632 (L-4175). See Instructions.
Acquisition
Year
Acquisition
Cost New
GAAP
Net Book Value
2020
2019
2018
Prior
H1
H2Total Acquisition Cost
SECTION I - Qualified Personal Property
INCLUDE ONLY "Qualified Personal Property" as defined by Michigan Compiled Laws 211.8a(6)(c). See instructions. If necessary,
attach extra schedules using the same format indicated below. Any Personal Property reported in this Section should NOT be reported
elsewhere on Form 632 (L-4175).
Description of Equipment
and Model or Serial Number
Owner Name and
Complete Mailing Address
Original Cost
Installed
Date of
Installation
Lease Term
In Months
Year of
Manufacture
Total Average
Monthly Rental
%
TCV to be Completed
by Assessor
Total Installed Cost
I1 I2
SECTION J - Leased Property in Your Possession Which Is Not Qualified Personal Property
Property you are leasing from another person or entity should be reported under this Section. "Qualified" Personal Property should be
reported under Section l. See instructions. Attach additional sheets if necessary. Any Personal Property reported in this Section should
NOT be reported elsewhere on Form 632 (L-4175).
Lease No. Name & Address of Lessor Description of Equipment
Lease Term
(in months)
Monthly
Rental
1st Year
in Service
Selling Price New
(estimate, if necessary)
Total Selling Price New
J1
SECTION K - Other Personal Property in Your Possession Which You Do Not Own
Property not owned by you but in your possession on December 31, 2020, under arrangements other than a lease agreement should
be reported under this Section. See instructions. Any Personal Property reported in this Section should NOT be reported elsewhere on
Form 632 (L-4175). Attach additional sheets if necessary.
Name & Address of Owner Description of Equipment
Age (estimate if
necessary)
Selling Price New
(estimate, if necessary)
Total Selling Price New
K1
COST GRAND TOTAL (for page 3)
TAXPAYER: Add Total Costs and
Selling Prices from Sections G-K
(G1-K1). Enter grand total here and
carry to line 10a, page 1.
$
TRUE CASH VALUE GRAND TOTAL (for page 3)
ASSESSOR: Add True Cash Value totals
from Sections G-I (G2-I2). Enter grand
$
total here and carry to line 10b, page 1.
632, Page 4
SECTION L - Detail of Leases (This Section is Completed by Leasing Companies)
Equipment that you lease to others should be reported under this Section. Note: You must also complete Sections A - F on Page 2. See instructions.
You may use attachments in lieu of completing this Section only if the attachments use the same format and contain all the information as indicated
below, and the Tables on Page 2 are completed. If you are leasing Eligible Manufacturing Personal Property (EMPP) to another company, you
must report it in this section unless an election has been made, using Form 5467, that it be reported on the lessee's Form 5278. See the
detailed notice at the beginning of the Instructions, at the top of the first column, Page 5. Attach additional sheets, if necessary.
Yes No
Are you a manufacturer of equipment?
Lease No. Name & Address of Lessee
Location of
Equipment
Type of
Equipment
Lease
Period (Mo.)
Monthly
Rental
1st Year
in Service
Manufacturer
Cost
Original
Selling Price
Total Original Selling Price
SECTION M - Leasehold Improvements
All Leasehold Improvements (LHI) made at your place of business should be reported under this Section, even if you believe that the improvements are
not subject to assessment as Personal Property. Report trade fixtures, foundation costs and equipment installation costs, including wiring and utility
connections in the appropriate Section A through F, on Page 2, not as LHI. See instructions. To prevent a duplicate assessment, provide as much detail
as possible. You may attach additional explanations and/or copies of "fixed asset" records, if the attachment provides ALL of the information requested
below and if you insert the total original cost in "Total Cost Incurred" below. Personal Property reported here should NOT be reported elsewhere on Form
632 (L-4175). Assessor: Do NOT assess 2016 or later installations as personal property except where the lease is pre-1984.
NOTICE: The State Tax Commission has directed that all leasehold improvement installations in 2016 or later must be valued as improvements to
the leased real property. Report all 2016, 2017, 2018, 2019 and 2020 leasehold improvements in the section immediately below.
STC
True Cash Value
Year Installed Description (Describe in detail) Original Cost Multiplier
Assessor's Calculation
2020
2019
2018
2017
2016
Prior
SECTION N - Buildings and Other Structures on Leased or Public Land and All Freestanding Signs and Billboards
Costs of Freestanding Communications Towers and Equipment Buildings at Tower sites (unless reported on Form 4452), and Costs of Freestanding
Signs and Billboards must also be reported under this Section. Any Personal Property reported in this Section should NOT be reported elsewhere on
Form 632 (L-4175). Attach additional sheets, if necessary.
Check this box if you believe that these structures are already assessed as part of the real property.
Address or Location of Building
Year Originally
Built
Total Capitalized
Cost
True Cash Value
Assessor's Calculation
*
Total Capitalized Cost
N1 N2
SECTION O - Rental Information. See Instructions. (Attach additional sheets, if necessary.)
IF YOU ARE THE TENANT
Name and address of landlord __________________________________________________________________________________
Is your landlord the owner of the property? Yes No If you are a sublessee, enter the name and address of the owner
of the property _______________________________________________________________________________________________
IF YOU ARE THE LANDLORD
Name and address of tenant ___________________________________________________________________________________
Are you the owner of the property? Yes No If you are a sublessor, enter the name and address of the owner of
the property ________________________________________________________________________________________________
TO BE COMPLETED REGARDLESS OF WHETHER YOU ARE THE LANDLORD OR TENANT
Address of property rented or leased ____________________________________________________________________________
Date that current rental arrangement began:_________. Square feet occupied:_________ Monthly rental $____________________
Date current lease expires:________________. Are there options to renew the lease? Yes No
Expenses (e.g. taxes, electric, gas, etc.) paid by the tenant ___________________________________________________________
Assessor Value
O2
COST GRAND TOTAL (for page 4) TRUE CASH VALUE GRAND TOTAL (for page 4)
TAXPAYER: Add Total Cost Incurred from
Section M and Total Capitalized Cost from ASSESSOR: Add True Cash Value totals
Section N (M1 and N1). Enter grand total
here and carry to line 11a, page 1.
$
from Sections M-O (M2-O2). Enter grand
total here and carry to line 11b, page 1.
$
* NOTE TO ASSESSOR: Certain buildings and structures on leased land (but not including freestanding signs and billboards) must be assessed on the
real property roll. See Bulletin 1 of 2003.


Instructions for Completing Form 632 (L-4175), 2021 Personal Property Statement
NOTICE: Do NOT report Eligible Manufacturing Personal
  
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Property Tax Exemption Claim, Personal Property Statement,
and Report of Fair Market Value of Qualied New and Previously
Existing Personal Property (Combined Document)
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local unit in which the personal property is located no later than
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
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Eligible Manufacturing Personal Property  

NOTICE: 
that you or a related party own, lease, or possess in this (“city”
       

         
IF YOU ARE ELIGIBLE FOR THE SMALL BUSINESS
TAXPAYER EXEMPTION (MCL 211.9o) AND FILE FORM
5076, YOU DO NOT HAVE TO COMPLETE THIS PERSONAL
PROPERTY STATEMENT.     

www.michigan.gov/
taxes





CAUTION: 
Complete all Sections. 
        
        
 
          
       

   Failure to le this form by its
due date will jeopardize your right to le an MCL 211.154
appeal with the State Tax Commission. You are advised to

         



   


   
    

   
   

FACSIMILE SIGNATURES:      
 





GENERAL EXPLANATION: 
         
 
       
       
      

         
   

it and return it to the assessor by the statutory due date,
 

    

the statutory due date, even if the assessor does not send you

COMPLETION OF FORM 632 (L-4175)
PAGE 1 — STATISTICAL INFORMATION:
FROM:      
       

         
         


TO:
      


Parcel No.:

         
        

Preparer’s Name and Address:    
        

(Check One):       
       
       
       
      
          

Location(s) of Personal Property: 


        

 
   



Date of Organization:    

Date Business Began at Above Location: 


Square Feet Occupied:      

Assumed Names:       

Names of Owner(s) or Partners:     


If Sole Proprietorship, Taxpayer’s Residential Address:
  

Legal Name of Taxpayer:     

Address Where Personal Property Records Are Kept: 


        

Name of Person in Charge of Records:
  

Telephone Number:

Description of Taxpayer’s Business activity: 
      

PAGE 1 — SUMMARY AND CERTIFICATION:
Page 1, Line 1:    
     
         
        

         
          




 

 
         
  
 
         
    
         





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        
  

  


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

      
        

possession in this location even if the property has been fully
expensed or depreciated for federal income tax or nancial
accounting purposes.       

Page 1, Line 4:       
whether you are a party to a contract relative to personal

        
your belief that another party to the contract is the proper party
       
only a security interest in personal property, in spite of the fact
  
        
interest holder(s), the nature of your interest, a description of

service, its original selling price when new and the address where
    

Page 1, Line 5:       
lessee (tenant) or a sublessee (subtenant) in a rental contract
       
    

      




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 
         
           
   
 
  



     
 


    




Page 1, Line 7: “Daily rental property” is tangible personal
property, having a cost new 
        
           
        

        
        
Itemized Listing of Daily Rental
Property       


Page 1, Line 8:      
businesses that share space with you at the location(s) of your

        
    

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 
         

Page 1, Line 10: 
          


Page 1, Line 11:  

  


Page 1, Line 12:       

    Idle Equipment, Obsolete
Equipment and Surplus Equipment Report, and carry the Total

        
process and that has been disconnected and is stored in a
    not “idle” if they are present as
       
   
        
OR is being disposed of
   

        
        
          
 
      
          
        


Page 1, Line 13: 
in Progress, as calculated on an accrual basis, based on the
      
     
is property of a personal property nature that has never
been in service and was in the process of being installed
        
     
 


Page 1, Line 14:        
        Cable
Television and Utility Personal Property Report 
Electric Distribution Cooperative Personal Property Statement,

  
 
Wind Energy System Personal
Property Report  

Page 1, Line 15: 
       Cellular
(Wireless) Site Equipment Personal Property Report, and carry
         

PAGE 2 — GENERAL INSTRUCTIONS FOR SECTIONS A
THROUGH F:
     


     
       

even if you have fully depreciated the asset or
have expensed the asset under Section 179 of the Internal
Revenue Code or under your accounting policies. All costs
reported must include freight, sales tax and installation
costs, even in cases where the cost was actually incurred by
        
       
the lessee has paid or will pay such costs, or will provide the

     

       
       
the property under generally accepted accounting principles,
including overheads and “indirect costs” associated with the
     
   



      
     
         
personal property in your possession or under your control in this



by the Page 1, Line 6 
       

  
      not  
        
      Page 1, Line 13

reported as construction in progress last year but which was

    




   
the Owner
property, using a cost which represents the price that would be
         

 
Page 1,
Line 7        







 




      
constructed the asset for your own use, report the price at which
 






      
include personal property under lease or principally intended
       
      

        

     
software, if the purchase was evidenced by a separate invoice
        




www.michigan.gov/taxes

personal property that were not assessed in this city or township
      
property (which should be reported in the year it was new and
 


       
do not include 
 within this city or township or assessed
  within       
property reported by a previous owner or previously leased

       

Do not report
          

        




    

the property for business purposes and which are both capable of


       
       
      

The costs of an electrical generating facility, including the costs
        
    
        
     
       

        
instructions to Page 1, Line 14.
The costs associated with a generating facility that does not have

 
       


 
    

        


        
site at www.michigan.gov/taxes.    
        
        

  
    

Completion of Section A, Page 2: The assets to be reported

     
    

  




      


Completion of Section B, Page 2: The assets to be reported
        
      

      
    
  
shop, boiler, furnace, bottling & canning, crane and hoist, car
     

    

    

      
      
    


     
     
restaurant food preparation and dispensing and storing and

       


      
        
       

    


  

Completion of Section C, Page 2: 



Completion of Section D, Page 2: The assets to be reported

     
     
      
      



       

  

     
     
 
     

are not capable
       

     
are not capable
       
        
     
       



the use of carbon paper or other duplicating processes can be


   
 

    
     

       
  

      


      



Completion of Section E, Page 2: The assets to be reported



      


Completion of Section F, Page 2: The assets to be reported in
  
     
       
     
     
      
     


     

which are capable of being integrated into a local area or wide
       
are capable of being used



Cost Grand Total, Page 2: 

          

Section G , Page 3:     
property owned by you at this location that is not entitled to
     
or that the assessor has told you to report in this
or    



    

         


have not been assessed as real property, nuclear fuel and toll
  


Section H, Page 3:   
      


      
         
       

   



        
        



 
       


     
useful life plus salvage value (if applicable under the depreciation

Section I, Page 3:   

  



      
        

        
       


st
of the current
 
in which it is specically agreed that you will report the property
 
Section J, Page 3:     

    
property that you are renting or leasing 
     
You must   
   
        
all tangible personal property shall be assessed to the owner
        
        

Section K, Page 3:     

that are in your possession but are not owned, leased or rented
   

loaned to you by another, property left with you for storage or

 
     must provide the



property shall be assessed to the owner thereof, unless the
 

Cost Grand Total, Page 3: 
    
          
    
Section L, Page 4:  
 
  


  
        

Section M, Page 4: 
      
   
   


      
      


   
     




Section N, Page 4:   
construction of buildings and other structures you have placed
on land not owned by you, such as leased or public lands or
    

        
billboards        


Section O, Page 4: 
       
   

        
     

Cost Grand Total, Page 4: 



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Form 2021: L-4175 2021 Personal Property Statement (As (Michigan)

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Completed 18 February 2022

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