Form 891 - Application For Water Pollution Control Tax Exemption Certificate Page 3
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3Form 891, Page 3
Instructions for Completing Form 891, Application for
Water Pollution Control Tax Exemption Certificate
GENERAL INSTRUCTIONS
TE-EQUIPMENT
One TE-SOURCE is required for each submittal; and one
The TE-EQUIPMENT provides information about water
TE-EQUIPMENT is also required. [IMPORTANT:
pollution control equipment that may be eligible for tax
Forms must be fully completed. An incomplete
exemptions. A separate page should be attached for each
application will be returned to the preparer
additional explanation. Each page must be identified as TE-
unprocessed.]
Equipment. Items 11, 14, 15 and 16 may require additional
space for explanation.
For full consideration in the year in which the material is
submitted, a complete application must be received by June
Part 5: Equipment and Cost Details
15. Mail THREE COPIES (no binders) of the completed
Provide a description of the equipment associated with the
forms and supplemental information (written narrative, list
water pollution control that is claimed to be exempt.
of equipment with individual costs, one set of plans) to:
Consider incremental costs when providing the value to be
Michigan State Tax Commission
considered for tax exemption. If a building is constructed
Department of Treasury
solely for the purpose of protecting a water pollution control
430 W. Allegan Street
device, the entire cost of the building may be tax exempt.
Lansing, MI 48922
If, however, the size of the building is increased to allow for
Telephone: 517-373-3272
additional warehouse space, the entire cost of the building
would not be tax exempt. (See Example 1.)
For guaranteed receipt by the State Tax Commission, it is
Line 16. Value of Recovered Product. Enter the gross
recommended that applications and attachments are sent
commercial or productive value derived from any materials
by certified mail.
captured or recovered by the water pollution control
LINE-BY-LINE INSTRUCTIONS
equipment calculated on a yearly basis. This is required per
Lines not listed are explained on the form. Complete all boxes
Sec. 3702(2).
or indicate N/A.
TE-SOURCE
Example 1
The TE-SOURCE provides general information about the
A building is constructed to protect a water pollution
facility including contact person and preparer identification.
control device and serve as a warehouse. To calculate
Complete a TE-SOURCE for each submittal. If additional
the tax exempt portion, the applicant must determine
space is required to complete an answer, attach additional
the total cost of the building, less the cost of the portion
pages.
of the building serving as a warehouse.
Part 1: Source Identification
Total Cost of Building
$100,000
This section pertains to the facility where the water pollution
Less Cost of Warehouse Portion
(80,000)
control equipment is located.
Tax Exempt Portion
$20,000.
Part 2: Technical Contact/Preparer Information
Enter the information in number 8 of the person who can
respond to technical questions about the application. If the
Preparer is different than Technical Contact Person, enter
the Preparer information in number 9.
Part 3: Company Official
The Company Official is required to be an employee of the
company that is seeking the tax exemption. The application
response will be sent to the Company Official. By signing
and dating this application, the Company Official authorizes
the Michigan Department of Treasury and the Michigan
Department of Environmental Quality to discuss this project
with the technical contact person named in Part 2.
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