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Michigan Department of Treasury
3966 (Rev. 09-21)
2022 Taxpayer Report of Personal Property "Move-Ins" of Used Equipment
(As of 12-31-21) Occurring During 2021
Issued under authority of Public Act 206 of 1893 (General Property Tax Act).
Owner's Name Doing Business As
Mailing Address (Street or RR#, City, State, ZIP Code) Business Location (Street or RR#, City, State, ZIP Code)
Name of Person to Contact Telephone Number Parcel Number
Do not report move-ins of NEW equipment on this form. Report in the appropriate sections below the acquisition cost and year-new of "Move-Ins" of USED
equipment. These costs must also be reported in the appropriate Section of Form 632 (L-4175), Personal Property Statement. See the instructions to Form
632 (L-4175) for guidance in determining the correct Section for reporting the costs. It is not necessary to include on this report any property reported on
Sections G, H, I or M of Form 632 (L-4175). "Move-Ins" are items of assessable personal property that were not assessed in this jurisdiction (city or
township) in 2021, including: acquisitions of previously used personal property (which should be reported in the year the property was new and at the cost
when new); used personal property you have moved in from a location outside this jurisdiction; personal property that was exempt in 2021 (such as exempt
Industrial Facilities Tax property); and, personal property that you mistakenly omitted from your statement in 2021.
"Move-Ins" DO NOT INCLUDE property that you have moved from another location WITHIN this city or township or that was assessed in this jurisdiction to
another taxpayer in 2021 (for example, property reported to this jurisdiction by a previous owner or previously leased property reported to this jurisdiction by
the lessor).
Section A - Including Section B - Including Section C - Including Section E - Including
Furniture and Fixtures Machinery and Fixtures Rental Videotapes Consumer Coin
and Games Operated Equipment
2021 2021
2021
2020 2020 2021
2020
2019 2019 2020
2019 2019
2018 2018
2018
2017 2017 2018
Prior
2016 2016 2017
0
Totals 2016
2015 2015
2014 2014 Section D - Including 2015
Office, Electronic, Video 2014
2013 2013 and Testing Equipment
2013
2012 2012
2021
2011 2011 2012
2020
2010 2010 2011
2019
Prior
2009 2009
2018 Totals 0
2008 2008
2017
2007 2007
2016 Section F - Including
Computer
Prior Prior
2015 Equipment
Totals 0 Totals 0
2014 2021
NOTE: This form must be signed by an owner, partner, corporate officer or 2013 2020
duly authorized representative.
2012 2019
CERTIFICATION
I hereby attest that, to the best of my knowledge and belief, all of the 2011 2018
property listed on this form is a "move-in" for this jurisdiction as that term is
defined in the instructions herein. 2010 2017
Signature 2009 2016
2008 2015
Name (Print or Type) Date
2007 Prior
Title (Print or Type) Prior Totals 0
Totals 0