Form 2691 (L-4037) "State Tax Commission Assessment Roll Certification" - Michigan

What Is Form 2691 (L-4037)?

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 May 1, 2011;
  • 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 2691 (L-4037) by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 2691 (L-4037) "State Tax Commission Assessment Roll Certification" - Michigan

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Michigan Department of Treasury
L-4037
2691 (Rev. 05-11)
State Tax Commission Assessment Roll Certification
(Assessor of Record, Pre-March Board of Review)
This form is issued under the authority of the General Property Tax Act, P.A. 206 of 1893, MCL 211.10d. Attach original copy to the assessment roll.
PART 1: ASSESSOR AND LOCAL UNIT INFORMATION
(This form must be filed with the MBOR by the first Monday in March or by the specified charter deadline.)
Assessing Officer Name
Certification Number
Certification Level (MCAO, MAAO, MMAO)
Tax Year
Local Unit of Government Name
City or Township
County Name
PART 2: PRE-BOARD OF REVIEW ASSESSED VALUES, CAPPED VALUES AND TENTATIVE TAXABLE VALUES – AD
VALOREM AND SPECIAL ACTS
Property Class
Assessed Values
Capped Values
Tentative Taxable Values
Real Agriculture
Real Commercial
Real Industrial
Real Residential
Real Timber Cutover
Real Developmental
TOTAL REAL
PROPERTY
TOTAL PERSONAL
PROPERTY
TOTAL OF REAL AND
PERSONAL PROPERTY
PART 3: ASSESSOR CERTIFICATION
I hereby certify that the information contained within this Assessor of Record Assessment Roll Certification is true and accurate to the best of my
knowledge, information and belief and that the valuations were prepared by myself as the assessing officer of record and pursuant to the guidelines
found within the State Tax Commission’s Supervising Preparation of the Assessment Roll document. I further certify that I have determined
that the Ad Valorem and Special Acts assessed, capped and tentative taxable valuations contained within this Assessor Certification Statement
compose the aggregate assessed valuations of taxable property for the above mentioned local unit of government prior to the March Board
of Review.
Assessing Officer Signature
Date
Reset Form
Michigan Department of Treasury
L-4037
2691 (Rev. 05-11)
State Tax Commission Assessment Roll Certification
(Assessor of Record, Pre-March Board of Review)
This form is issued under the authority of the General Property Tax Act, P.A. 206 of 1893, MCL 211.10d. Attach original copy to the assessment roll.
PART 1: ASSESSOR AND LOCAL UNIT INFORMATION
(This form must be filed with the MBOR by the first Monday in March or by the specified charter deadline.)
Assessing Officer Name
Certification Number
Certification Level (MCAO, MAAO, MMAO)
Tax Year
Local Unit of Government Name
City or Township
County Name
PART 2: PRE-BOARD OF REVIEW ASSESSED VALUES, CAPPED VALUES AND TENTATIVE TAXABLE VALUES – AD
VALOREM AND SPECIAL ACTS
Property Class
Assessed Values
Capped Values
Tentative Taxable Values
Real Agriculture
Real Commercial
Real Industrial
Real Residential
Real Timber Cutover
Real Developmental
TOTAL REAL
PROPERTY
TOTAL PERSONAL
PROPERTY
TOTAL OF REAL AND
PERSONAL PROPERTY
PART 3: ASSESSOR CERTIFICATION
I hereby certify that the information contained within this Assessor of Record Assessment Roll Certification is true and accurate to the best of my
knowledge, information and belief and that the valuations were prepared by myself as the assessing officer of record and pursuant to the guidelines
found within the State Tax Commission’s Supervising Preparation of the Assessment Roll document. I further certify that I have determined
that the Ad Valorem and Special Acts assessed, capped and tentative taxable valuations contained within this Assessor Certification Statement
compose the aggregate assessed valuations of taxable property for the above mentioned local unit of government prior to the March Board
of Review.
Assessing Officer Signature
Date
Michigan Department of Treasury
L-4037
Form 2691, page 2 (Rev. 05-11)
State Tax Commission Assessment Roll Certification (Board of Review)
This form is issued under the authority of the General Property Tax Act, P.A. 206 of 1893, MCL 211.30. Attach original copy to the assessment roll.
PART 1: ASSESSOR AND LOCAL UNIT INFORMATION
Assessing Officer Name
Certification Number
Certification Level (MCAO, MAAO, MMAO)
Tax Year
Local Unit of Government Name
City or Township
County Name
PART 2: POST-BOARD OF REVIEW ASSESSED VALUES, CAPPED VALUES AND TENTATIVE TAXABLE VALUES – AD
VALOREM AND SPECIAL ACTS
Property Class
Assessed Values
Capped Values
Tentative Taxable Values
Real Agriculture
Real Commercial
Real Industrial
Real Residential
Real Timber Cutover
Real Developmental
TOTAL REAL PROPERTY
TOTAL PERSONAL
PROPERTY
TOTAL OF REAL AND
PERSONAL PROPERTY
PART 3: BOARD OF REVIEW CERTIFICATION
We hereby certify that the information contained within this Board of Review Assessment Roll Certification is true and accurate to the best of our
knowledge, information and belief and that the Ad Valorem and Special Acts assessed, capped and tentative taxable valuations contained within
this Board of Review Certification compose the aggregate assessed valuations of taxable property for the above mentioned local unit of government
following the conclusion of the Board of Review.
Chairperson of the Board of Review Signature
Date
Board of Review Member Signature
Date
Board of Review Member Signature
Date
Board of Review Member Signature (if necessary)
Date
Board of Review Member Signature (if necessary)
Date
Board of Review Member Signature (if necessary)
Date
Michigan Department of Treasury
L-4037
2691, Page 3 (Rev. 05-11)
State Tax Commission Assessment Roll Certification
(County Board of Commissioners, CBC)
This form is issued under the authority of the General Property Tax Act, P.A. 206 of 1893, MCL 211.34. Attach original copy to the assessment roll with
copies provided to the local unit and county clerk.
PART 1: ASSESSOR AND LOCAL UNIT INFORMATION
(When complete, this form is to be filed with the local unit of government)
Assessing Officer Name
Certification Number
Certification Level (MCAO, MAAO, MMAO)
Tax Year
Local Unit of Government Name
City or Township
County Name
PART 2: CBC ASSESSED VALUE AS EQUALIZED – AD VALOREM
ADDING OR
GIVING ASSESSED
THE SUM OF
FROM OR TO
PROPERTY CLASS
DEDUCTING
VALUE AS EQUALIZED
Real Agriculture
Real Commercial
Real Industrial
Real Residential
Real Timber Cutover
Real Developmental
TOTAL REAL
PROPERTY
TOTAL PERSONAL
PROPERTY
TOTAL OF REAL
AND PERSONAL
PROPERTY
PART 3: COUNTY BOARD OF COMMISSIONERS CERTIFICATION
We hereby certify that the information contained within this County Board of Commissioners Assessment Roll Certification is true and accurate to the
best of our knowledge, information and belief. We further certify that the County Board of Commissioners have examined the Assessment Roll of the
above mentioned local unit of government and have determined the equalized valuations of the taxable Ad Valorem and Special Acts property to be
accurate.
Chairperson of the County Board of Commissioners Signature
Date
Clerk of the County Board of Commissioners Signature
Date
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