Form 3595 - Itemized Listing Of Daily Rental Property - 2009

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Michigan Department of Treasury
3595 (Rev. 9-08)
2009 Itemized Listing of Daily Rental Property
(as of 12-31-08)
INSTRUCTIONS: Use this form to provide the itemized listing of "daily rental property" required by Section 8c of P.A. 206 of 1893, as
amended. "Daily rental property" is assessed to the owner at the location of the rental business and is not assessable at its location on
December 31, 2008 (hereafter referred to as "Tax Day") if certain requirements are met. See the reverse side of this form for the
definition of "daily rental property" and for the requirements that must be met to qualify. Property reported on this form must also be
reported in the appropriate sections, A through F, of the owner's Form L-4175 (Form 632), Personal Property Statement. Assessable
personal property that does not qualify as daily rental property must be reported by the owner at the location of the property on Tax
Day. Report the acquisition cost NEW of the daily rental property including sales tax, freight and installation. Property must be listed
on this form in the order of the year that it was placed in service, placing more recent years before earlier years. If additional space is
needed, attach additional sheets using Form 3612, 2009 Itemized Listing of Daily Rental Property.
Owner's Name
Doing Business As
Mailing Address (Street or RR#, City, State, ZIP)
Rental Business Location (Street or RR#, City or Township, State, ZIP)
Name of Person to Contact
Telephone Number
Parcel Number
Year
Acquisition Cost New
Description of Property
Manufacturer's
Make and/or
Serial Number
Placed in
(Rounded to the
I.D. No.
Service
nearest dollar)
(Please be specific)
Name
Model
(If assigned)
1. TOTAL ACQUISITION COST (THIS PAGE)
2. TOTAL ACQUISITION COST FROM ALL
ADDITIONAL SHEETS (Form 3612)
3. TOTAL ACQUISITION COST - ALL SHEETS
(ADD 1 AND 2 ABOVE)
CERTIFICATION
I, ______________________________________, hereby attest that, to the best of my information, knowledge and belief,
the property shown above and on all attached sheets is qualified as daily rental property as that phrase is defined in the
instructions on the reverse side of this form. On behalf of the taxpayer, I give the assessor receiving this form permission to
provide a copy of the information provided herein to the assessor of any other city or township in which the daily rental
property may have been physically located on tax day.
Signature
Date
Title (Please print or type)

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