Form L-4175 - Personal Property Statement - 2015 Page 3
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4Form 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 L-4175. See instructions. Attach additional sheets, if necessary.
Acquisition
Acquisition
True Cash Value
Description of Property
Cost New
Year
Assessor's Calculations
Total Acquisition Cost New
G1
G2
SECTION H - Standard Tooling
Acquisition
Acquisition
GAAP
You must report your standard tooling in this Section. Complete both
Year
Cost New
Net Book Value
columns. Notice that GAAP (Generally Accepted Accounting Principals)
2014
net book value, as reported in this section, must implement accounting
2013
"changes in estimate", even if not otherwise material. Any Personal
2012
Property reported in this section should not be reported elsewhere on
Prior
Form L-4175. See Instructions.
Total Acquisition Cost
H2
H1
SECTION I - Qualified Personal Property
INCLUDE ONLY "Qualified Personal Property" as defined by Michigan Compiled Laws 211.8a (6)(c). See instructions. Attach extra
schedules, if necessary, following the same format as below. Any Personal Property reported in this section should not be reported
elsewhere on Form L-4175.
Description of Equipment
Owner Name and
Original Cost
Date of
Lease Term
Year of
Total Average
TCV to be Completed
%
and Model or Serial Number
Complete Mailing Address
Installed
Installation
In Months
Manufacture
Monthly Rental
by Assessor
I1
I2
Total Installed Cost
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 L-4175.
Lease Term
Monthly
1st Year
Selling Price New
Lease No.
Name & Address of Lessor
Description of Equipment
(in months)
Rental
in Service
(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, 2014 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
L-4175. Attach additional sheets if necessary.
Age (estimate if
Selling Price New
Name & Address of Owner
Description of Equipment
necessary)
(estimate, if necessary)
Total Selling Price New
K1
COST GRAND TOTAL (for page 3)
TRUE CASH VALUE GRAND TOTAL (for page 3)
TAXPAYER:
Add Total Costs and
ASSESSOR: Add True Cash Value totals
Selling
Prices
from
Sections
G-K
from Sections G-I (G2-I2). Enter grand
(G1-K1). Enter grand total here and
$
$
total here and carry to line 9b, page 1.
carry to line 9a, page 1.
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