Examples of how to fill out SAC’s most commonly required forms.
Determination forms
Transmittal-A Example (207 KB, PNG image)
All fields are required unless otherwise noted. Please note this is just an example form; you will enter your own information in each field.
Transmittal-B Example (208 KB, PNG image)
Fill out only what applies to your business. The business owner must sign and date the bottom. Please note this is just an example. You will enter your own information in each field.
Affidavit-A Example (177 KB, PNG image)
All fields are REQUIRED unless otherwise noted. Please note this is just an example. You will enter your own information in each field. If you have outdoor seating in your restaurant, you will need to include that on your floor plan as well. Don't forget to digitally sign or print form and sign.
Affidavit-B Example (169 KB, PNG image)
Used for all manufacturing businesses. Please note this is just an example. You will enter your own information in each field. Don't forget to digitally sign or print form, and sign.
Local government SAC reporting forms
SAC-A – SAC Activity Report (208 KB, PNG image)
This form is the summary of permit and payment activity for the reporting period. If the payment is not from your current permit activity, the dollar value is entered on the adjustment line (towards the end of the form on right side). See a copy of what can be submitted for your adjustment documentation (80 KB PNG image).
SAC-B – Residential Detail Report
This form is required to document all new residential activity that was issued for the reporting period. There are two forms:
SAC-C – Commercial Detail Report (196 KB, PNG image)
This form is required to document all nonresidential activity for the reporting period and change-of-use activity for nonresidential properties (including commercial, nonprofit, governmental and institutional). Other options:
- Submit a copy of the SAC Determination Letter (192 KB, PNG image), and a copy of the building permit (195 KB, PNG image)
- Submit a copy of the SAC determination letter with the address, building permit number, building permit issue date written on the letter (396 KB, PNG image)
SAC-D – Demolition Declaration Report (151 KB, PNG image)
This form is required to document all full building demolition activity. This form establishes a potential future credit for the site and is required to be submitted in order for demolition credit to be applied to a future new use. The demolition must be reported to MCES to be creditable. Monthly reporting is recommended.
The SAC-D form is not valid without all columns filled in and the following attachments:
- Nonresidential demolitions must be accompanied by the SAC-C form or a copy of the MCES SAC Determination Letter
- Industrial property demolitions must be accompanied by a copy of the SAC Determination Letter