Form 3828 - Application For Air Pollution Control Tax Exemption Certificate Page 4
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53828, Page 4
Instructions for Completing Form 3828,
Application for Air Pollution Control Tax Exemption Certificate
GENERAL INSTRUCTIONS
Part 1: Source Identification
This section pertains to the facility where the air pollution
One TE-SOURCE is required for each submittal; and one
control equipment is located.
or both TE-EQUIPMENT or TE-PROCESS is also
Line 2. AQD Source ID (SRN). Enter the state registration
required. Complete the number of forms appropriate for your
situation. Multiple TE-Equipment and TE-Process forms may
number for your facility issued by the DEQ.
be filed under one TE-Source [IMPORTANT: Forms must
Line 3. Primary SIC Code. Enter the Standard Industrial
Classification (SIC) code that best describes the major product
be fully completed. An incomplete application will be
or service produced. This code must be a four digit numeric
returned to the preparer unprocessed.]
code not ending in zero based upon the Standard Industrial
For full consideration in the year in which the material is
submitted, a complete application must be received by June
Classification Manual (1987), or a six-digit code based upon
15. Mail THREE COPIES (no binders) of the completed
the North American Industry Classification System (1997).
forms and supplemental information (written narrative, list of
Part 2: Technical Contact/Preparer Information
equipment with individual costs, one set of plans) to:
Enter the information in #8 of the person who can respond to
Michigan Department of Treasury
technical questions about the application. If the Preparer is
State Tax Commission
different than Technical Contact Person, enter the Preparer
P.O. Box 30471
information in #9.
Lansing, MI 48909-7971
Part 3: Company Official
Telephone Number: (517) 373-
The Company Official is required to be an employee of the
For guaranteed receipt by the State Tax Commission, it is
company that is seeking the tax exemption. The application
recommended that applications and attachments are sent by
response will be sent to the Company Official. By signing
certified mail.
and dating this application, the Company Official authorizes
the Michigan Department of Treasury and the DEQ to discuss
Refer to the following Department of Environmental Quality
this project with the technical contact person named in Part
(DEQ) Web site documents for assistance in completing an
2.
air pollution control tax exemption application:
TE-EQUIPMENT
DEQ Air Quality Web site
The TE-EQUIPMENT provides information about air
,1607,7-135,3310---,00.html
pollution control equipment that may be eligible for tax
DEQ Air Pollution Guidance Document
exemption. If a tax exemption is being sought for equipment
w w w. d e q . s t a t e . m i . u s / d o c u m e n t s / D E Q - A Q D -
from multiple emission units, complete a separate form for
Tax_exemption_application_guidance_document.pdf
each emission unit. A separate page should be attached
DEQ Permit Guide Book
for each additional explanation. Each page must be identified
as TE-Equipment or TE-Process along with the corresponding
permitguidebook.pdf
Emission Unit name from box 14. Applications with more
DEQ Operational Memorandum #6 – Emissions Units
than one explanation per page will not be accepted. Items 19
thru 24 may require additional space for explanation.
DEQ Environmental Permits,Licenses & Certifications
Part 4: General Information
,1607,7-135-6132_6830---
Line 13. AQD Source ID (SRN). Enter the state registration
,00.html
number for your facility issued by the DEQ.
Line 14. Emission Unit. If the equipment is part of a Renewable
LINE-BY-LINE INSTRUCTIONS
Operating Permit, Permit to Install, or is reported in the
Lines not listed are explained on the form. Complete all boxes
Michigan Air Emission Reporting System (MAERS), it may
or indicate N/A.
have an emission unit associated with it. If so, enter the
TE-SOURCE
name of the emission unit to which it belongs. If not, the
The TE-SOURCE provides general information about the
Michigan Department of Environmental Quality , Air Quality
facility including contact person and preparer identification.
Division (DEQ/AQD), “Operational Memorandum No. 6”
Complete a TE-SOURCE for each submittal. If additional
will assist you in defining one for your facility . A separate
space is required to complete an answer , attach additional
TE-EQUIPMENT should be submitted for each
pages.
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