Form 4287 - Tax Exemption Certificate For Donated Motor Vehicle
Download a blank fillable Form 4287 - Tax Exemption Certificate For Donated Motor Vehicle in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 4287 - Tax Exemption Certificate For Donated Motor Vehicle with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Reset Form
Michigan Department of Treasury
4287 (Rev. 2-05)
Tax Exemption Certificate for Donated Motor Vehicle
Donation by a Regularly Organized Church or House of Religious Worship
Motor Vehicle Transfers Beginning 04/01/05 and Ending 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.
The individual has a valid Michigan operator's or chauffeur's license. License #___________________________________
Public transportation or other reliable transportation is not reasonably available and the individual will use the eligible vehicle
as his or her primary means of transportation to commute to and from his or her place of employment.
If the individual is currently employed for not less than an average of 20 hours per week, the individual requires an
automobile to retain his or her current employment or to accept a verified offer of employment in a position that is
demonstrably superior to his or her current position of employment.
If the individual is not currently employed or is employed for less than an average of 20 hours per week, the individual
requires an automobile to accept a verified offer of employment of not less than an average of 20 hours per week and cannot begin
employment in that position without an automobile.
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 all of the qualifications listed in Part A.
Telephone Number
Name and Title of Authorized Representative (print or type)
(
)
Signature of Authorized Representative
Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form S-3v - Vermont Sales Tax Exemption Certificate For Registrable Motor Vehicles Other Than Cars And Trucks
Financial
Form Ft-1001 - Exemption Certificate For Diesel Motor Fuel Interdistributor Transactions - 2006
Financial
Form Ft-1001 - Exemption Certificate For Diesel Motor Fuel Interdistributor Transactions - Nys Department Of Taxation
Financial
Form R-1044 - Sales Tax Exemption Certificate For Purchases Of Motor Vehicles By The Chitimacha Indian Tribe Or Its Tribal Government Agencies
Financial
Related Categories
Parent category: Financial