Form 4863 "Real Property Statement for Commercial and Industrial, and Apartment Property Owners" - Michigan

What Is Form 4863?

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 June 1, 2017;
  • 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;

Download a fillable version of Form 4863 by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 4863 "Real Property Statement for Commercial and Industrial, and Apartment Property Owners" - Michigan

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CONFIdeNtIAl
Michigan Department of Treasury
Reset Form
4863 (06-17)
Real Property Statement
For Commercial and Industrial, and Apartment Property Owners
This form is issued under authority of the General Property Tax Act. (See Section 211.21 on page 3 of this form.) Filing is mandatory. Willful failure to file
is punished by fine and/or imprisonment. Approved by the State Tax Commission on May 14, 2013.
NAme ANd AddReSS:
mAIl thIS COmPleted StAtemeNt tO:
PARt 1: PROPeRty INFORmAtION
Property Type (If mixed use, check both)
Date Property Acquired
Purchase Price
Date of Mortgage
Expiration Date of Mortgage
Commercial and Industrial
Interest Rate
Mortgage Payment
Original Mortgage Balance
Current Mortgage Balance
Apartment
Parcel Code Number
Property Address
PARt 2: GeNeRAl leASe INFORmAtION FOR COmmeRCIAl ANd INduStRIAl ReNtAl PROPeRty
Owners of commercial and industrial rental property, complete the table below and attach a copy of the most typical, current
lease. Attach an additional sheet if needed. do not report residential rental information in Part 2.
level — e.g.
Gross
Net leasable
length
Base Rent
Basis for Rent
Basement
tenant Name
leasable Area
Area
1st Floor, etc. date of lease
of lease
Rate
Above Base Rate
Information for
currently vacant areas.........
..........................................................................................
Total....................................
..........................................................................................
PARt 3: GeNeRAl leASe INFORmAtION FOR APARtmeNt PROPeRty
Owners of apartment property, complete Part 3. Report only residential rental information in Part 3.
Utilities Paid by Tenant (Check all that apply.)
No. of
No. Currently
Apartment type
Apartments
Vacant
Current monthly Rent Per unit
Electric
Water
Gas
1 Bedroom 1 Bath
Major Appliances Furnished by Landlord
2 Bedroom 1 Bath
2 Bedroom 2 Bath
3 Bedroom 1 Bath
Additional Amenities Furnished by Landlord
3 Bedroom 2 Bath
___ Bedroom ___ Bath
Total No. of Apartments
Continue on sign on Page 2
CONFIdeNtIAl
Michigan Department of Treasury
Reset Form
4863 (06-17)
Real Property Statement
For Commercial and Industrial, and Apartment Property Owners
This form is issued under authority of the General Property Tax Act. (See Section 211.21 on page 3 of this form.) Filing is mandatory. Willful failure to file
is punished by fine and/or imprisonment. Approved by the State Tax Commission on May 14, 2013.
NAme ANd AddReSS:
mAIl thIS COmPleted StAtemeNt tO:
PARt 1: PROPeRty INFORmAtION
Property Type (If mixed use, check both)
Date Property Acquired
Purchase Price
Date of Mortgage
Expiration Date of Mortgage
Commercial and Industrial
Interest Rate
Mortgage Payment
Original Mortgage Balance
Current Mortgage Balance
Apartment
Parcel Code Number
Property Address
PARt 2: GeNeRAl leASe INFORmAtION FOR COmmeRCIAl ANd INduStRIAl ReNtAl PROPeRty
Owners of commercial and industrial rental property, complete the table below and attach a copy of the most typical, current
lease. Attach an additional sheet if needed. do not report residential rental information in Part 2.
level — e.g.
Gross
Net leasable
length
Base Rent
Basis for Rent
Basement
tenant Name
leasable Area
Area
1st Floor, etc. date of lease
of lease
Rate
Above Base Rate
Information for
currently vacant areas.........
..........................................................................................
Total....................................
..........................................................................................
PARt 3: GeNeRAl leASe INFORmAtION FOR APARtmeNt PROPeRty
Owners of apartment property, complete Part 3. Report only residential rental information in Part 3.
Utilities Paid by Tenant (Check all that apply.)
No. of
No. Currently
Apartment type
Apartments
Vacant
Current monthly Rent Per unit
Electric
Water
Gas
1 Bedroom 1 Bath
Major Appliances Furnished by Landlord
2 Bedroom 1 Bath
2 Bedroom 2 Bath
3 Bedroom 1 Bath
Additional Amenities Furnished by Landlord
3 Bedroom 2 Bath
___ Bedroom ___ Bath
Total No. of Apartments
Continue on sign on Page 2
Page 2, Form 4863
PARt 4: ACtuAl INCOme dAtA FOR thRee mOSt CuRReNt yeARS
For year ending:
For year ending:
For year ending:
type of data
12/31/_______
12/31/_______
12/31/_______
most Current
Previous
Next Previous
Total Gross Income
Misc. Income - Parking
Misc. Income - Other
PARt 5: ACtuAl exPeNSe dAtA FOR thRee mOSt CuRReNt yeARS
Detail specific expenses under “Other Expenses.” Attach an additional sheet if needed.
Check if
Check if
For year ending:
For year ending:
For year ending:
expenses Paid
expenses Paid
12/31/_______
12/31/_______
12/31/_______
type of data
by tenant
by Owner
most Current
Previous
Next Previous
Property Taxes
Insurance
Management
Utilities
Repairs & Maintenance
Rubbish Removal
Snow Removal
Janitorial
Legal & Accounting
Advertising
Supplies
Other Expenses
Other Expenses
Other Expenses
total expenses
PARt 6: CeRtIFICAtION
I hereby certify that this statement, including any attachments, is complete and true to the best of my knowledge and belief.
Signature of Owner (Buyer)
Date
Telephone Number
See “Excerpts from the General Property Tax Act” on Page 3
Page 3, Form 4863
exCeRPtS FROm the GeNeRAl PROPeRty tAx ACt deFINING the POWeRS ANd dutIeS OF the lOCAl
ASSeSSOR ANd COuNty eQuAlIZAtION dePARtmeNt FROm SeCtIONS 211.19, 211.21 ANd 211.23 OF the
mIChIGAN COmPIled lAWS
211.19(3) ... If a supervisor, an assessing officer, a county tax or equalization department provided for in section 34, or the
state tax commission considers it necessary to require from any person a [written] statement of real property
assessable to that person, it shall notify the person, and that person shall submit the statement.
211.19(5) ... A statement under subsection (2) or (3) shall be in a form prescribed by the state tax commission. If a local
tax collecting unit has provided for electronic filing of the statement under subsection (4), the filing format
shall be prescribed by the state tax commission. The state tax commission shall not prescribe more than 1
format for electronically filing a statement under subsection (2) or more than 1 format for electronically filing a
statement under subsection (3).
211.19(6) ... A statement under subsection (2) or (3) shall be signed manually, by facsimile or electronically. A supervisor
or assessor shall not require that a statement required under subsection (2) or (3) be filed before February 20
of each year.
211.21 ....... If a person, member of a firm, or officer of a corporation willfully neglects or refuses to make out and deliver
a statement required under section 18 [now 211.19] or falsely answers or refuses to answer questions
concerning his or her property or property under his or her control as required by this act, that person is
guilty of a misdemeanor, punishable by imprisonment in the county jail for not less than 30 days or more than
6 months, or by a fine of not less than $100.00 or more than $1,000.00, or both. If a supervisor, assessing
officer, or member of the state tax commission is satisfied that a person is liable under this section, he or she
shall report the case to the prosecuting attorney of the county in which the property is located.
211.23 ....... All the statements herein required to be made and received by the supervisor or assessor shall be filed
by him, and shall be presented to the board of review hereinafter provided for, or provided for in any act
incorporating any village or city, for the use of said board, and after the assessment is reviewed and
completed by such board of review, all of the statements shall be deposited in the office of the township or
city clerk, and shall be preserved until after the next assessment is made and completed, after which they
may be destroyed upon the order of the township board or city or village council, but no such statement
shall be used for any other purpose except the making of an assessment for taxes as herein provided,
or for enforcing the provisions of this act, and any officer or person who shall make or allow to be made
wilfully or knowingly, any other or unlawful use of any such statement, shall be liable to the person making
such statement for all damages resulting from such unauthorized or unlawful use of such statement. All the
statements received by the supervisor or assessor shall be made available to the county tax or equalization
department mandatorily established under section 34 of this act and use of such statements by such county
tax or equalization department shall be deemed a use for the purpose of enforcing the provisions of this act.
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