Form 471 - Application For Deferment Of Summer Taxes
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1Michigan Department of Treasury
471 (Rev. 03-12)
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Application for Deferment of Summer Taxes
Issued under the authority of Public Act 206 of 1893; MCL 211.51
INSTRUCTIONS: File this application with the treasurer of your city, village, or township. You may file your intent to defer before
September 15, or before the date your summer taxes are due, whichever is later. Do NOT file this application with the Michigan
Department of Treasury.
NOTE: Though filing this form is voluntary, your tax due date will not be extended unless this form is filed. The local treasurer may
require additional documentation to verify your claim.
PART 1: APPlicANT iNfORMATiON
Last Name
First Name
M.I.
Property Identification Number
Telephone Number
Address of Principal Residence (street number and name, city, state, ZIP code)
Name of City, Township, or Village (taxing authority)
City
Township
Village
PART 2: DefeRMeNT iNfORMATiON
I hereby request that the Treasurer of the above-noted municipality defer the due date of the summer taxes on the property identified
above, without penalty or interest charges, until February 15 (payment must be received on or before February 14 to avoid penalty
and interest) based on the following qualification:
(Check 1 or 2 below to identify your basis for this application. Select one choice only.)
Principal Residence:
1.
I certify that my gross household income for the preceding calendar year did not exceed $40,000 and that I qualify for
the deferment provided for in the General Property Tax Act under the classification marked below:
62 years of age or older, including the unmarried surviving spouse of a person who was 62 years of age or older
at the time of death
Paraplegic, Hemiplegic, or Quadriplegic
Eligible Serviceperson, Eligible Veteran, Eligible Widow or Widower
Blind Person
Totally and Permanently Disabled
Agricultural Real Property:
2.
I certify that I own the above property, which is classified or used as agricultural real property, and that the gross
receipts of agricultural or horticultural operations in the previous year (or the average gross receipts for such
operations in the previous three years) are not less that my household income for the preceding calendar year or the
combined household incomes in the previous year of the individual members of a limited liability company or partners
of a partnership that owns the agricultural real property.
PART 3: CERTIfICATION
I understand that if this deferment is approved, the deferred taxes must be paid on or before February 14 in order to avoid penalty and interest.
I also understand that misleading or false statements on this application may subject me to penalties and interest for late payments of taxes.
Applicant’s Signature
Date
fOR CITy, vIllAgE, OR TOwNShIP USE ONly
Deferment Approval Signature
Date
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