scpetition_nonprop.pdf
Reuben Joel Burnside Petitioner Vs. Michigan Department Of Treasury Respondent · 26-002308-TT
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STATE OF MICHIGAN GRETCHEN WHITMER GOVERNOR DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS LANSING MARLON I. BROWN, DPA DIRECTOR TAX APPEAL PETITION FORM NON-PROPERTY TAX MTT DOCKET NO. Section 1: Petitioner’s Contact Information Filer Type: Individual Local Unit of Government First Name Reuben M.I. Joel Last Name/Company Name Burnside Mailing Address (No., Street, P.O. Box or Rural Route) 2447 Alder Drive City or Town Fruitport Charter Township State Michigan ZIP Code 49415 Telephone Number 2698326519 E-mail Address rsk7379@gmail.com Section 3: Explain the Reason for this Appeal I was charged a equalization for a Michigan Use Tax of a motor vehicle purchase. This is in accurate based on what was paid for the vehicle and condition. Section 4: Assessment Information Type of Tax Being Assessed: Michigan Use Tax Assessment Number(s): 1989381 Check all that are being appealed: Tax Interest Penalty Pursuant to Michigan Tax Tribunal Rule (TTR) 277(3), you MUST submit a copy of the notice giving rise to the appeal (e.g. notice of action taken by the Michigan Department of Treasury) with this Small Claims Petition, if applicable. If you do not submit this document, you may be held in default.
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STATE OF MICHIGAN GRETCHEN WHITMER GOVERNOR DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS LANSING MARLON I. BROWN, DPA DIRECTOR Check what action prompted this appeal: (Check one) Final Assessment If “other,” explain: List the Amounts being levied: Tax 1248.00 Interest 150 Penalty 312 List the refund sought, if any: 1710 List your Contentions: Tax 1248 Interest 150 Penalty 312 Fee Information A fee of $100.00 is required for the filing of a Non-Property Tax Appeal. Electronic Signature *Typing your name below will serve as your signature Petitioner or Attorney/Authorized Representative’s Signature: Reuben Burnside /s/ Payment Information Amount: 100 Success: True Message: "" Waiver Code: Transaction Number: 26061389278251 Supporting Waiver Documents: