HomeMy WebLinkAboutlansing michigan form 4887 2-1-13 filing executed Michigan Department or Treasury
4887(08-12)
Economic Vitality Incentive Program/County Incentive Program
Certification of Consolidation of Services
Issued under authority of 2012 Public Act 200.Filing is mandatory to qualify for payments.
Each city/village/township/county applying for Consolidation of Services payments must:
1. Certify to the Michigan Department of Treasury (Treasury) that the local unit listed below has produced and made readily
available to the public, a consolidation plan as required by 2012 Public Act 200. The plan shall be made available for
public viewing in the clerk's office or posted on a publicly accessible Internet site.
2. Submit to Treasury a consolidation plan.
City/village/township: This certification, along with a consolidation plan, must be received by February 1, 2013 to receive the
February and April payments or on or before March 31,2013 to receive the April payment. Post mark dates will not be considered.
For questions, call (517) 373-2697.
County: This certification, along with a consolidation plan, must be received by February 1, 2013 (or the first day of a payment
month) in order to qualify for that month's payment. Post mark dates will not be considered. For questions, call (517) 373-2697.
PART 1: LOCAL UNIT INFORMATION
Local Unit Name Local Unit County Name
City of Lansing Ingham
Local Unit Code Contact E-Mail Address
332020 chad.gamble@lansingmi.gov
Contact Name Contact Title Contact Telephone Number
Chad Gamble Chief Operating Officer (517) 483-4146
Website Address,if plan is available online
www.lansingmi.gov
PART 2:CERTIFICATION
In accordance with 2012 Public Act 200, the undersigned hereby certifies to Treasury that the above mentioned local unit has
produced a consolidation plan and has made the plan available for public viewing in the city, village, township, or county clerk's
office or has posted the plan on a publicly accessible Intemet site. The consolidation plan is attached to this signed certification.
Chief Administrative Officer Sjgrfure(as defined in MCL 141.422b) Printed Name of Chief Administrative Officer(as defined in MCL 141.422b)
Virg Bernero
Title Date
Mayor I I S�
Completed and signed form (including required attachment) should be e-mailed to: TreasRevenueSharing@michigan.gov
If you are unable to submit via e-mail, mail the completed form and required attachment to:
Michigan Department of Treasury
Office of Revenue and Tax Analysis
PO Box 30722
Lansing MI 48909
TREASURY USE ONLY
EVIP/CIP Certification Received EVIP/CIP Notes
Y N
Final Certification Plan Received
1 st C/P Submission
Y N