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Michigan Department of Treasury                                             Parcel Number 
5076 (Rev. 11-22) 
                                                                                                                                                                 2023 

Small Business Property Tax Exemption Claim Under MCL 211.9o 
This form is to be filed 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 filed no later than February 21, 2023 (postmark is acceptable).  Late filed forms 
may be filed directly with the 2023 March Board of Review prior to the closure of the March Board. 
This form must be filled out in it’s entirety. Failure to fill 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                                                                                County Where the Property is Located 
 City:______________________ Township:______________________ Village:______________________ 
 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.) 

 Value of Personal Property 
      The True Cash Value of all Personal Property, as defined by MCL 211.9o, located within the local tax       Value of Personal Property 
      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, 2022. (Enter value at right.) 
      The True Cash Value of all Personal Property, as defined by MCL 211.9o, located within the local tax       Value of Personal Property 
      collecting unit indicated above, that is owned by, leased to, or in the possession of the owner or related 
      entity, was equal to or greater than $80,000 and less than $180,000 on December 31, 2022. (If checked, 
      attach a copy of Form 632, “2023 Personal Property Statement,” to this form. Enter value at right.) 
The undersigned certifies 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 following procedures were used to determine that the True Cash Value of the Eligible Personal Property on December 31, 2022: 
   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 fixtures and may include leasehold improvements not assessed as real property. Attach an 
      explanation if not all personal property is included. 
3.     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. 
4.     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 

 Signature                                                                                                       Date 

                                                                                                                 LOCAL UNIT USE 
                                                                                  Date Received 

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 defines “eligible personal property” as meeting all of the following criteria: 
       • The personal property must be classified as industrial personal property or commercial personal property as defined in MCL 211.34c 
or would be classified 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 $180,000 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. 

Personal Property Valued Less than $80,000 
In order to claim an exemption for personal property valued less than $80,000, this form must be filed with the local unit (City or  
Township) where the personal property is locatedno later thanFebruary 21, 2023 (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 filed forms may be filed 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 file with the March Board of Review. 
Once the exemption is granted for personal property valued at less than $80,000, 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 file 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 file the rescission form will result in significant penalty and interest as prescribed in MCL 211.9o. 
This form will exempt property owned only by the entity filing 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 file the form for that property, not the lessee or the user. The owner 
may file 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, 2022. 
This form must be filled out in it’s entirety. Failure to fill 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. 
Once an exemption is granted for personal property valued at less than $80,000, taxpayers are not required to file a “Personal Property 
Statement” (Form 632) in the year they are claiming the exemption. 

Personal Property Valued Greater than or Equal to $80,000 but Less than $180,000 
In order to claim an exemption for personal property valued at $80,000 or more but less than $180,000, this form along Form 632 
Personal Property Statement must be filed ANNUALLY with the local unit (City or Township) where the personal property is located 
no later than February 20 of each year (postmark is acceptable). If February 20 is a Saturday, Sunday, or legal holiday, this form and 
accompanying personal property statement must be filed the next day that is not a Saturday, Sunday, or legal holiday of that year. 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 filed forms may be filed 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. 
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 website at www.michigan.gov/ 
statetaxcommission.