PRE Submission and Denial_Redacted.pdf

Alexandra M Rothermel Petitioner V City Of Fenton Respondent · 26-001223-TT

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Michigan Department of Treasury 

4640 (Rev. 04-19) 

| ASSESSOR'’S DATE STAMP 

Conditional Rescission of Principal Residence Exemption (PREY 

Issued under authority of Public Act 206 of 1893. 

MAR 

0 ? Ub 

Read the instructions before completing the form. This form must be filed with the assessor for the city or 

township where the property is located on or before June 1 or November 1 of the first year the exemption is 

claimed. This form must be submitted to the assessor annually on or before December 31 to verify the 

0 

property still complies with the conditional rescission requirements in order to receive the exemption for the following year. 

valid unless certified by the assessor (in Part 5). Use a separate form for each property tax identification number. 

Mail the completed form (Parts 1 through 4) and necessary documentation to the assessor for the city or township in which the property 

is located. The assessor's address may be on the most recent tax bill or assessment notice. Do not send this form directly to the 

Department of Treasury. If you have any questions, contact your local assessor or the PRE Unit of the Michigan Department of Treasury at 

517-335-7487, or visit www.michigan.gov/PRE. 

Type or print in blue or black ink. 

PART 1: CONDITIONAL RESCISSION TYPE 

is 

form is not 

1. Check the box that corresponds to your conditional rescission (check one box only) 

2. Applicable Tax Year (yyyy) 

L 

"‘nitial Request 

Second Year Annual Verification 

Il Third Year Annual Verification 

PART 2: PROPERTY INFORMATION (Prior Principal Residence for which the applicant is claiming a Conditional Rescission.) 

3. Property Tax Identification Number 

4. Name of Local Unit (Check Township or City)[ 

5. County 

— 

— 

Township 

on 

53-23-3578- 

007 

oq on 

Greneses 

6. Street Address of Property (Provide a Complete Address) 

2076 

S 

Lo ng Ledee 

4d 

7. Name of Owner (First, Middle, Last) 

8. Owner's Last 

umber | 9. Owner's Daytime Telephone Number 

Alexavdia, Mave Eobiomaed 

| 0xxx- 

248 BoB -341 0 

10. Name of Co-Owner (First, Middle, Last) 

11. Co-Owner’s La 

y Number | 12. Co-Owner’s Daytime Telephone Number 

JRussell 

Conv Ne 

XXX-XX- 

BA - bet l-7543 

13. Is the property currently for sale? 

ie else currently occupyllive in the home located on the. property? 

Yes 

[1] No 

] Yes 

No 

If yés,'enter an MLS listing or provide other proof that the property is currently 

for sale. 

15. Is the property currently leased? 

[ves 

X No 

16. When was the property listed for sale? (mm/dd/yyyy) 

17. Is the property used for any business or commercial purpose? 

/1D-28~202Y 

[Jes 

Mino 

PART 3: CURRENT PRINCIPAL RESIDENCE (Attach a current tax bill and PRE Affidavit (Form 2368) for the current PRE.) 

18. To where did the owner(s) move? (Provide a complete address.) 

19. Coty 

[3453 Lok Show Dr 

Meng see 

A 

y5 

amy 

20. Property Tax Identification Number 

Farben 

MI 4g8UZO 

Dlo- 

|4= SS) ~ 620 

21. Date Current Principal Residence Purchased (mm/ddlyyyy) 

22. Date Property First Occupied as Principal Residence (mm/dd/yyyy) 

[D~14 -202Y 

(0-5-2024 

PART 4: OWNER CERTIFICATION 

Certification: | certify, under penalty of perjury, that the information provided on this document is true and correct to the best of my knowledge. 

23. Owner's Signature 

24. Date 

TON N__— 

12-3 j-2025 

25. Co-owner's Signature 

26. Date 

27. Owner's Current Mailing Address 

City 

N 

State 

ZIP Code 

i345? Loka Shore 

Di 

Fenton 

Jo 

Ygdz0 

PART 5: ASSESSOR’S CERTIFICATION — FOR LOCAL GOVERNMENT USE ONLY 

Did the assessor approve or deny the Conditional Rescission? 

What is the year the Conditional 

i 

2 

. 

Rescission 

will by 

ted to th 

[TJApproved 

[Hosnied (Attach a copy of the Local Unit Denial (Form 2742).) 

tax roll? Gryay) 

8 psied 

tothe 

Certification: | certify that, to the best of my knowledge, the information contained in this form is complete and accurate. 

Assessor's Signature 

Date Certified by Assessor (mm/dd/yyyy) 

5 inne 

Zosapman P) 

5 3-Ale

“Wichigan Department of Treasury 

u 

. 

2742 (Rev. 08-23) 

Local (City/Township) 

ASSESSOR'S DATE STAMP. 

GEIVED ASSESSOR 

MAR 03 2 

CITY OF FENTON 

Notice of Denial of Principal Residence Exemption 

RE 

Issued under authority of Public Act 206 of 1893 

With this notice, you are notified that the Principal Residence Exemption on the property identified below has 

been denied. If you have questions about the denial, you may contact your local government or follow the 

appeal procedures specified below. For more information regarding the Principal Residence Exemption (PRE), 

please review the PRE guidelines at www.michigan.gov/pre. 

Type or print in blue or black ink 

PART 1: PROPERTY INFORMATION Type or print legibly. Use a separate form for each property number. 

1. 

Property tax identification number 

2. Name of Local Unit (Check Township or City)] 

3. County 

Township 

53-23-578-007 

City 

GENESEE 

4. 

Streetaddress of property (Provide a Complete Address) 

2076 S LONG LAKE RD 

5. 

Name of Owner (First, Middle, Last) 

6. Owner's Last Four Digits of Social Security Number 

7. 

Owner's Daytime Telephone Number 

CARR JR, J RUSSELL & 

KXX-XX- 

471 - oqf- 7543 

8. 

Name of Co-Owner (First, Middle, Last) 

9. 

Co-Owner's Last 

pgp 

ecurity Number | 10. Co-Owner's Daytime Telephone Number 

YY - €0%- 

3 

{0 

Rotrermed, AMexandioo 

XXX-XX- 

11. 

Mailing address if different than property address (street or RR#, city, state, Zip code) 

13453 rake Shore. Dr. Fenton 

MI dgdzo 

12. Your exemption was denied/adjusted for the following reason: 

0 

a. The owner is not a Michigan resident. 

0 

b. The property claimed is not the owner's principal residence. 

O 

¢. The person claiming the exemption is not the owner. 

O 

d. The person claiming 

the exemption, claimed or was granted, a substantially similar exemption in another state. 

Re ower_Condlitiinal Kesesssire was not timely 4iled for anaug 

are 

sli 

[i] 

TEATEE 

13. “Claim Denied for Calendar Year(s): 

14. 

Percentage Adjusted to: 

(see instructions) 

0s 

O % 

PART 2: CERTIFICATION 

15. Name of the Local Assessor (Print or Type) 

Tonya Lad ( 

16. Signajure of Local Assesso 

17. 

Date 

Torre 

all 

3-3-A 

18. Address and Tglephone Rlumber of Local Government 

S01 S. (eroye&St, Fenton MI 43430 

(glo) (029 -22( 

19. 

Email Address of Assessbr 

Tel L@ Ladyotfenton. org 

J 

Homeowner's Right to Appeal 

If you disagree with this denial, you may appeal to the Residential/Small Claims Division of the Michigan Tax Tribunal within 35 

days of the denial. An appeal with the Michigan Tax Tribunal can be initiated by the timely filing of a petition. The petition must 

be a Michigan Tax Tribunal form or a form approved by the Michigan Tax Tribunal. Michigan Tax Tribunal forms are available at 

www.michigan.gov/taxtrib. You can print the Petition for Denial of Exemption for Principal Residence/Qualified Agricultural and 

mail the completed form to the Michigan Tax Tribunal at P.O.Box 30232, Lansing, Michigan 48909 or complete the form online 

and submit electronically, if provided for by the Michigan Tax Tribunal.

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