Refund-Request-Form-fillable.pdf
Cjs Holdings Of Warren, LLC, Petitioner Vs. City Of Warren, Respondent · 25-001814-TT
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STATE OF MICHIGAN GRETCHEN WHITMER GOVERNOR DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS LANSING MARLON I. BROWN, DPA DIRECTOR MICHIGAN TAX TRIBUNAL · 611 W. OTTAWA ST., LANSING, MI 48933 · 517-335-9760 PO BOX 30232, LANSING, MI 48909 · Other Carriers: 2407 N. GRAND RIVER AVE., LANSING, MI 48906 MICHIGAN TAX TRIBUNAL REFUND REQUEST Payee Name: ______________________________________________________________ Payee Address: ____________________________________________________________ MTT Docket No: _______________________Amount of Refund Requested: $___________ Reason for Refund: ☐Filing/Motion Fee Overpaid ☐Duplicate Docket ☐Other _____________________________________________________________ __________________________________________________________________ Payment Information: Docket Lookup Line # of Payment: ______________________________________________ Date of Payment: ___________________________________________________________ Check #:___________________________________________________________________ Validation/Confirmation #:_____________________________________________________ Requestor’s Signature:_______________________________________________________ __________________________________________________________________________ For Tribunal Use Only: Computation of Refund Amount: Amount paid: $______________________ Granted: ☐ Amount Due: $______________________ Denied: ☐ Amount Refunded: $______________________ Prepared by:____________________________ Date: Authorized by:___________________________ Date: Audited/Entered by:_______________________ Date: Refund Denied by:________________________ Date: ________________ Barry Steinway 5851 Cherrywood, Apt 1901, West Bloomfield, MI 48322 25-001814 50.00 Stipulation for Consent Judgment had a typo for the assessed value so it was refiled and I was charged another filing fee of $50. The communication from the tribunal said there would not be a duplicate fee for filing the corrected stipulation. November 24, 2025 /s/Barry Steinway 13 25112457128662