Michigan Department of Treasury
5076 (Rev. 07-21)
Parcel Number
2022
Small Business Property Tax Exemption Claim Under MCL 211.9o
This form is to be led with the local unit (City or Township) where the personal property is located. Please contact the local unit where
the personal property is located for their mailing address. This form IS NOT to be mailed to the Michigan Department of Treasury or
Michigan State Tax Commission. This form must be led no later than February 22, 2022 (postmark is acceptable). Late led forms
may be led directly with the 2022 March Board of Review prior to the closure of the March Board.
This form must be lled out in it’s entirety. Failure to ll out the form completely can be cause for denial of the exemption. Taxpayers should
pay particular attention to including contact information, including phone number and email address.
General Information
Business Name
Name and Mailing Address of Owner(s) or Partners (if sole proprietorship or partnership) - attach a separate sheet if necessary
Name of Local Unit of Government
City:______________________ Township:______________________ Village:______________________
County Where the Property is Located
Parcel Number Assumed Name(s) Used by Legal Entity (if any) Owner Telephone Number
Date Business Began in Local Tax Collecting Unit Description of Owner’s Business Activity
Name, Telephone Number and Email Address of the Person in Charge of Personal Property Records Address Where Personal Property Records are Kept
Names of all other businesses having personal property, including any leasehold improvements assessed as personal property at the location(s) included in this form.
(Attach additional sheets as necessary.)
List all addresses where any personal property owned by, leased to, or in the possession of the owner listed above or a related entity is located within the local tax collecting
unit. (Attach additional sheets as necessary.)
The undersigned certies that:
1. I am the owner of the commercial personal property and/or industrial personal property being claimed as exempt or I am the duly authorized agent.
2. The True Cash Value of all the Personal Property, as dened by MCL 211.9o located within the local tax collecting unit indicated above, that is owned by, leased to, or in the
possession of the owner or related entity was less than $80,000 on December 31, 2021.
3. The following procedures were used to determine that the True Cash Value of the Eligible Personal Property was less than $80,000 on December 31, 2021:
a) The determination of True Cash Value was based on the State Tax Commission’s recommended valuation procedures as set forth on Form 632 (L-4175), Personal
Property Statement.
b) The determination of True Cash Value includes all assessable personal property, located within the city or township listed on this form that is owned by, leased to, or
in the possession of the owner or related entity. This shall include all trade xtures and may include leasehold improvements not assessed as real property. Attach an
explanation if not all personal property is included.
4. I understand that according to MCL 211.9o, I am required to maintain and provide access to books and records for audit purposes as provided in section 22.
5. All of the information contained within Form 5076 is true and accurate and to the best of my knowledge and belief, and I acknowledge a fraudulent claim for exemption under
MCL 211.9o is subject to the penalties as provided for in section 21(2).
Printed Name Title Date
Signature
LOCAL UNIT USE ONLY
Date Received
Reset Form
5076, Page 2
Instructions for Small Business Property Tax Exemption Claim Under
MCL 211.9o (Form 5076)
MCL 211.9o provides for a personal property tax exemption for “eligible personal property”. This is commonly referred to as the
Small Business Taxpayer Exemption. MCL 211.9o denes “eligible personal property” as meeting all of the following criteria:
The personal property must be classied as industrial personal property or commercial personal property as dened in MCL 211.34c
or would be classied as industrial personal property or commercial personal property if not exempt and
The combined true cash value of all industrial personal property and commercial personal property owned by, leased by or in the
possession of the owner or a related entity claiming the exemption is less than $80,000 in the local tax collecting unit and
The property is not leased to or used by a person that previously owned the property or a person that, directly or indirectly controls,
is controlled by, or under common control with the person that previously owned the property.
In order to claim this exemption, this form must be led with the local unit (City or Township) where the personal property is
located no later than February 22, 2022 (postmark is acceptable). This form IS NOT to be mailed to the Michigan Department of
Treasury or the Michigan State Tax Commission. Please contact the local unit where the personal property is located for their
mailing address. Late led forms may be led directly with the local unit March Board of Review prior to the closure of the March
Board of Review. Taxpayers must contact the local unit directly to determine the March Board of Review dates.
Taxpayers must appear in person or have a representative appear on their behalf in order to late le with the March Board of Review.
Once the exemption is granted, the taxpayer will continue to receive the exemption until they no longer qualify for the
exemption. Once they no longer qualify, the taxpayer is required to le a rescission form and a personal property statement
no later than February 20th of the year that the property is no longer eligible. Failure to le the rescission form will result in
signicant penalty and interest as prescribed by P.A. 132 of 2018: “An owner who fails to le a rescission and whose property
is later discovered to be ineligible for the exemption is subject to repayment of any additional taxes with interest at a rate of
1% per month or fraction of a month and penalties computed from the date the taxes were last payable without interest or
penalty.”
This form will exempt property owned only by the entity ling the form. If personal property is leased to or used by an entity other
than the property’s owner, the owner of that personal property must le the form for that property, not the lessee or the user. The
owner may le the form and claim the exemption only if the True Cash Value of all of the commercial or industrial personal property
located within the local tax collecting unit that is owned by, leased to, or in the possession of the owner or a related entity was less
than $80,000 on December 31, 2021.
This form must be lled out in it’s entirety. Failure to ll out the form completely can be cause for denial of the exemption. Taxpayers
should pay particular attention to including contact information, including phone number and email address.
Taxpayers who le Form 5076 are not required to le a Personal Property Statement (Form 632) in the year they are claiming the
exemption.
NOTICE: Questions regarding this form should be directed to the assessor of the city or township where the personal property
is located. This form is issued under the authority of Public Act 206 of 1893. Additional detailed information on the Small
Business Taxpayer Personal Property Exemption can be found on the State Tax Commission Web site at www.michigan.gov/
statetaxcommission.