Form 4288 "Tax Exemption Certificate for Donated Motor Vehicle" - Michigan

What Is Form 4288?

This is a legal form that was released by the Michigan Department of Treasury - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2005;
  • The latest edition provided by the Michigan Department of Treasury;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 4288 by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 4288 "Tax Exemption Certificate for Donated Motor Vehicle" - Michigan

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Michigan Department of Treasury
4288 (Rev. 2-05)
Tax Exemption Certificate for Donated Motor Vehicle
Donation by a Regularly Organized Church or House of Religious Worship
Motor Vehicle Transfers Occurring After 09/30/05
Issued under authority of P.A. 435 of 2004.
INSTRUCTIONS: Under the Vehicle Donation Program, a qualified recipient of a donated motor vehicle is exempt from tax on
that motor vehicle under the Use Tax Act, MCL 205.94w. To claim an exemption from use tax, an authorized representative of a
Regularly Organized Church or House of Religious Worship must certify that the recipient of the donated motor vehicle meets
all the qualifications listed in Part A below.
The representative must complete this certificate and provide the original to the
qualified recipient who must present it to the Office of the Secretary of State when the motor vehicle is registered.
PART A: RECIPIENT AND QUALIFICATIONS
Name of Individual Receiving Donated Motor Vehicle
Donated Vehicle Identification Number
Check all qualifications that apply to the recipient of the donated motor vehicle.
The individual receives or, if he or she applied, would be eligible to receive public assistance through a program created
and administered under the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.
OR
The individual has a total household income below 200 percent of the federal poverty guidelines updated annually in the
federal register of the United States Department of Health and Human Services.
The individual has a valid Michigan operator's or chauffeur's license. License #___________________________________
PART B: CHURCH OR HOUSE OF RELIGIOUS WORSHIP INFORMATION AND CERTIFICATION
Name of Regularly Organized Church or House of Religious Worship
Street Address
City
State
ZIP Code
CERTIFICATION. I certify that (a) I am an authorized representative of the regularly organized church or house of religious
worship qualified under Section 501(c)(3) of the Internal Revenue Code of 1986 and (b) the individual receiving the donated
motor vehicle named above meets the qualifications listed in Part A.
Name and Title of Authorized Representative (print or type)
Telephone Number
(
)
Signature of Authorized Representative
Date
Reset Form
Michigan Department of Treasury
4288 (Rev. 2-05)
Tax Exemption Certificate for Donated Motor Vehicle
Donation by a Regularly Organized Church or House of Religious Worship
Motor Vehicle Transfers Occurring After 09/30/05
Issued under authority of P.A. 435 of 2004.
INSTRUCTIONS: Under the Vehicle Donation Program, a qualified recipient of a donated motor vehicle is exempt from tax on
that motor vehicle under the Use Tax Act, MCL 205.94w. To claim an exemption from use tax, an authorized representative of a
Regularly Organized Church or House of Religious Worship must certify that the recipient of the donated motor vehicle meets
all the qualifications listed in Part A below.
The representative must complete this certificate and provide the original to the
qualified recipient who must present it to the Office of the Secretary of State when the motor vehicle is registered.
PART A: RECIPIENT AND QUALIFICATIONS
Name of Individual Receiving Donated Motor Vehicle
Donated Vehicle Identification Number
Check all qualifications that apply to the recipient of the donated motor vehicle.
The individual receives or, if he or she applied, would be eligible to receive public assistance through a program created
and administered under the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.
OR
The individual has a total household income below 200 percent of the federal poverty guidelines updated annually in the
federal register of the United States Department of Health and Human Services.
The individual has a valid Michigan operator's or chauffeur's license. License #___________________________________
PART B: CHURCH OR HOUSE OF RELIGIOUS WORSHIP INFORMATION AND CERTIFICATION
Name of Regularly Organized Church or House of Religious Worship
Street Address
City
State
ZIP Code
CERTIFICATION. I certify that (a) I am an authorized representative of the regularly organized church or house of religious
worship qualified under Section 501(c)(3) of the Internal Revenue Code of 1986 and (b) the individual receiving the donated
motor vehicle named above meets the qualifications listed in Part A.
Name and Title of Authorized Representative (print or type)
Telephone Number
(
)
Signature of Authorized Representative
Date