Chapple.pdf

Debbie A Chapple Petitioner V Township Of Swan Creek Respondent · 26-000869-TT

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GRETCHEN WHITMER 

GOVERNOR 

STATE OF MICHIGAN 

LANSING 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

RECEIVED 

APR 06 2026 

MICHIGAN TAX TRIBUNAL 

MARLON [. BROWN, DPA 

DIRECTOR 

PROPERTY TAX APPEAL PETITION FORM 

POVERTY EXEMPTION 

Do not use this form to appeal Principal Residence Exemption, Qualified Agricultural Exemption, Disabled Veterans 

Exemption, or other exemption disputes, 

Pursuant 

to Tax Tribunal Rule (TTR) 279, you MUST submit a copy of the notice giving rise to the appeal {i.e., Board of 

Review Decision or other notice) with this petition. 

If you do not submit this document, you may be held in default, 

Section 1: Petitioner's Contact Information 

First Name 

« 

M1 

No 

e/Company Name 

ew blbe 

2 

IA apple 

Malling Address (No., Stregt, P.O. Box or Rural Route) 

La 

VT 

CEE N Ra 

Aan 

Dr. 

Stat 

ZIP Cod. 

ly or 

Town 

a y 

ode 

Te 

pro) 

Lo 

TS 

er 168 —AG 

57 ( ert) 

Emall Address (do not enter unless you want 

MTT to send all correspondence via email) 

Section 2: Petitioner's Attorney/Authorized Representative’s Contact Information 

First Name 

Last Name 

Firm Name {if any) 

Mailing Address (No., Street, P.O. Box or Rural Route) 

City or Town 

State 

2IP Code 

Telephone Number 

Email Address {do not enter unless you want MTT to send all correspondence via email} 

Section 3: Subject Property Information 

"5 en 

ber: 

- 08 - A2/ Y— oop 

Taxing Authottly (City or Township) eek 

Pro; 

erty Address {No., Street} 

233] Jnana 

Dr. 

City or = 

9 

State 

¢ 

ZIP Code 

SOc neLed) 

aginced 

Vi 

207 

Tic.

STATE OF MICHIGAN 

" 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON |. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

Section 4: Explain the Reason for this Appeal 

I applic &/ Soe Property eremplion (Poverte,) 

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TFneompled «= Applica Lrore 

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Section 5: Jurisdictional Issues 

Did you request a poverty exemption at a Board of Review (BORD Yes 

[J No 

if Yes, check which BOR you attended; KJ March 

O July 

[Mi] December 

if No, please explain: 

Date the BPR 

decisfon was issued: 

2/14/30 

TaxySar(s) dehiéd: 

2004p 

Fee Information 

There is no fee required for the fiting of a poverty exemption appeal. 

Signature *required 

oy Attorney/Authorized Representatives Signature: 

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STATE OF MICHIGAN 

" 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON 1. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

PAPER FILING INSTRUCTIONS FOR POVERTY EXEMPTION APPEAL 

Follow these instructions for completing this Small Claims petition form. 

For questions 

that are not answered by these instructions, please visit the Tribunal's website at 

www. michigan.govftaxtrib or contact the Tribunal at 517-335-9760. 

Mail the completed form to: 

Michigan Tax Tribunal 

611 W. Ottawa St., Lansing, MI 48933 

U.S. Postal Mailing Address: PO BOX 30232, Lansing, MI 48908 

Other Carriers (UPS, FedEx, DHL): 

2nd Floor MTT, 2407 N. Grand River Avenue, Lansing, Mi 48906 

Section 1: Petitioner's Contact Information: “Petitioner” is the person, business, or 

entity filing the appeal. 

Section 2: Petitioner's Attorney/Authorized Representative’s Contact Information: 

Petitioner does not have to be represented by an attorney or authorized representative 

to file an appeal with the Tribunal. 

If Petitioner is represented, provide all contact 

information for the attorney or authorized representative. 

If Petitioner elects to have an 

attorney or authorized representative, only the attorney or authorized representative will 

receive notices and other documents from the Tribunal. 

IMPORTANT: If the contact information for Petitioner or Petitioner's attorney or 

authorized representative, 

if listed, includes an email address, the Tribunal will use that 

email address to electronically serve all future notices and documents issued by the 

Tribunal. Once an email address is provided, a request to opt out of electronic service 

must be made in writing. 

Section 3: Subject Property Information: 

» 

Parcel Identification Number: Provide the parcel number of the property being 

appealed. 

« 

Property Address: Provide the address of the property being appealed. 

Include 

Street address, City or Town, County, State, and Zip Code. 

« 

Taxing Authority: Provide the name of the city OR township (not both) where 

the property being appealed is located.

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STATE OF MICHIGAN 

© 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON I. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

« 

If Yes, check which BOR you attended: If Petitioner requested a poverty 

exemption at a BOR, indicate whether the application was considered by the 

March, July, or December BOR. 

« 

If No, explain why: If Petitioner did not request a poverty exemption at 

a BOR, 

explain the reason(s) why. 

« 

Date the BOR decision was issued: Identify the date listed on the BOR 

decision. 

+ 

Tax year(s) denied: Identify the tax years for which a poverty exemption was 

denied. 

Fee Information: There is no fee for filing a poverty exemption appeal. 

If you also wish 

to dispute the valuation of the property, a valuation petition form must be separately 

filed, along with the required filing fee, 

if applicable. 

Signature: If Petitioner is unrepresented, Petitioner must sign the petition form. 

If an 

attorney or other authorized representative is identified in Section 2 of the petition form, 

the petition form must be signed by that attorney or authorized representative and not 

petitioner. 

REMINDERS: 

Pursuant to TTR 279, a copy of the Board of Review decision or other notice 

giving rise to the appeal must be submitted with the petition. 

You must submit the original, completed, signed petition form to the Tribunal. 

You 

should also keep a copy for yourself. 

The Tribunal will issue a Notice of Filing after an answer is filed and indicate the case is 

ready for the scheduling of a hearing. 

The Tribunal will send a notice of hearing to the parties no less than 45 days in advance 

of the hearing. 

To check the status of your appeal, visit our website at www.michigan.gov/taxtrib and 

click on the "Docket Search” option.

Michigan Department of Treasury 

5737 (Rev. 10-25), Page 1 of 4 

Application and Affirmation for MCL 211.7u Poverty Exemption 

This form is issued under the authority of the General Property Tax Act, Public Act 206 of 1893, MCL 211.7u. 

MCL 211.7u of the General Property Tax Act, Public Act 206 of 1893, provides a property tax exemption for the principal 

residence of persons who, by reason of poverty, are unable to contribute toward the public charges. This application is 

to be used to apply for the exemption and must be filed with the Board of Review where the property is located, This 

application may be submitted to the city or township where the property is located in each year on or after January 1 but 

before the day prior to the last day of the board of review. Poverty Exemptions may be heard by the Board of Review 

during its March, July, and December sessions. 

To be considered complete, this application must: 1) be completed in its entirety, 2) include information regarding ail 

members residing within the household, and 3} include all required documentation as listed within the application. Please 

write legibly and attach additional pages as necessary. 

PART 1: PERSONAL INFORMATION — Petitioner must list all required personal information. 

Pejiloners 's, Nay 

7 

Debbie Chowple. 

GG 

Phone TES 1948 

Number of Legal Dependents 

= 

fi 

Le 

of Pelitioner 

pre 

Status 

Properly 

Ad TESS 

ncipal 

njesidence 

BY 

Slagle 

9533 | 

ohana Dr. 

Age of “rn 

A 

/ 

< 

State 

| 

ZIP Code, 

Peery 

/ 

PART 2 REAL ESTATE INFORMATION 

SY ged ) 

List the real estate information related to your principal res 

evidence of ownership of the property at the Board of Revi 

idence. Be prepared to provide a deed, land contract or other 

ot 

“TR ry 4 _ O00 

ew meeting. 

Name 

of Mortgage Company 

Fran 

erimety Opeit Linon 

. 

Unpgjd Balance Owed on dl g¢" 

He 

Payment. 

£4 3, ¥O¥X 

555.5 7 

1 LE ry 

Length of Time at this Residence 

Kt gens 

(Ja8x 

( 

~ Descripfion J a Subdivision See. 08 T7240 RIE 

Property ClassiPred as 

Hol Res jclentie! 

PART 3: AFFIRMATION OF OWNERSHIP, OCCUPANCY, AND INCOME STATUS (Check all. boxes that apply.) 

Jetfom the property in which the exemption is being claimed. 

I! The property in which the exemption is being claimed is used as my homestead. Homestead is generally defined 

as any dwelling with its land and buildings where a family makes its home. 

PART 4: ADDITIONAL PROPERTY INFORMATION 

List information related to any other property owned by you or any member residing in the household. 

0 

Check if you own, or are buying, other property. 

If checked, complete the 

Amount of Income Earned from other Property

5737, Page 2 of 4 

PART 5: EMPLOYMENT INFORMATION — List your current employment information. 

Name of Employer 

K oddme 

Address of Employer 

] \ WW 

Cily 

State 

ZIP Code 

AE 

Contact Person 

| 

Nd 

\ 

V 

Employer Telephone Number 

PART 6: INCOME SOURCES 

List all income sources, including but not limited to: salaries, Social Security, rents, pensions, IRAs (individual 

retirement accounts), unemployment compensation, disability, government pensions, worker’s compensation, 

dividends, claims and judgments from lawsuits, alimony, child support, friend or family contribution, reverse morigage, 

or any other source of income, for all persons residing at the property. 

Monthly or Annual Income 

Source of Income 

(indicate which) 

Soeiecd Seer 14 

}, 3 0]. 90 ee A fi 

Pebust 

Ne 

PART 7: CHECKING, SAVINGS AND INVESTMENT INFORMATION 

List any and all savings owned by all household members, including but not limited to: checking accounts, savings 

accounts, postal savings, credit union shares, certificates of deposit, cash, stocks, bonds, or similar investments, for all 

persons residing at the property. 

Name of Financial Institution 

Amount 

Current 

Value of 

or yr 

rt 

on Deposit 

|Interest Rate 

Name on Account 

Investment 

Frank 

esl 

[24 

res 

7 Lio Oleek Lrg. 

208,70 | 

Deboredr Chole 

Fr renlenmdt Hh pr redid #957 Ou HB 

Debora 0 huge 

Limo Sing < 

PART 8: LIFE INSURANCE — List all policies held by all household members. 

Amount of 

Monthly 

Policy Paid in 

Relationship to 

Name of Insured 

Policy 

Payments 

Full 

Name of Beneficiary 

Insured 

Deboced: Chal 

/0, Dd) Pesi6 

- 

Shes Hang 

Fest 

ON 

Like 

nal 

PART 9: MOTOR VEHICLE INFORMATION

5737, Page 3 of 4 

PART 10: HOUSEHOLD OCCUPANTS — List all persons living in the household. 

First and Last Name 

Age 

Relationship 

to Applicant 

Place of Employment 

$ Contribution to 

Family Income 

PART 11: PERSONAL DEBT — List ali personal debt for all household members. 

Creditor 

Purpose of Debt 

of Dent 

Original Balance [Monthly Payment] 

Balance Owed 

Foul 

Hpuce Put 

[20195 | 

104 S000 Fss55:27 P43 508.9 

VAY; 

lacy) : 

Arelotaad] 

8,23 

2 / 9054) 

Kol 

ph 

(relt 

T3969 

|\BI23.0I- 

£1 Jon nd 

Crem 

F99.00 Ploy 

Fou 

Ord ead’ 

BH, 0p 

2) 349,28 

PART 12: MONTHLY EXPENSE INFORMATION 

necessary. 

The amount of monthly expenses related to the principal residence for each category must be listed. Indicate N/A as 

hoes ne 

meta GL 

"9 18), 32, 

"B50 

cell 

| 

#25, )7) 

b <0 7/74) Fr all 

oe DE Bm 

ies Cireds)

5737, Page 4 of 4 

NOTICE: Per MCL 211.7u(2)(b), federal and state income tax returns for all persons residing in the principal residence, 

including any property tax credit returns, filed in the immediately preceding year or in the current year must be submitted 

with this application. Federal and state income tax returns are not required for a person residing in the principal residence 

if that person was not required to file a federal or state income tax return in the tax year in which the exemption under this 

section is claimed or in the immediately preceding tax year. 

PART 13: POLICY AND GUIDELINES ACKNOWLEDGMENT 

The governing body of the local assessing unit shall determine and make available to the public the policy and 

guidelines used for the granting of exemptions under MCL 211.7u. In order to be eligible for the exemption, the 

applicant must meet the federal poverty guidelines published in the prior calendar year in the Federal Register by the 

United States Department of Health and Human Services under its authority to revise the poverty line under 42 USC 

9902, or alternative guidelines adopted by the governing body of the local assessing unit so long as the alternative 

guidelines do not provide income eligibility requirements less than the federal guidelines. The policy and guidelines 

must include, but are not limited to, the specific income and asset levels of the claimant and total household income 

and assets. The combined assets of all persons must not exceed the limits set forth in the guidelines adopted by the 

local assessing unit. 

Se applicant has reviewed the applicable policy and guidelines adopted by the city or township, including the 

specific income and asset levels of the claimant and total household income and assets. 

PART 14: LEGAL DESIGNEE INFORMATION (Complete if applicable.) 

Legal Designee Name 

Daytime Telephone Number 

Mailing Address 

City 

State 

ZIP Code 

PART 15; CERTIFICATION 

| hereby certify to the best of my knowledge that the information provided in this form is complete, accurate and 

| am 

eligible for the exemption from property taxes pursuant to Michigan Compiled Law, Section 211.7u. 

Printed Name 

Deb hi (hsp le 

JO (Nips 

Shag ) 02s 

This application shall be filed after January 1, but before the day prior to the last day of the local unit's December 

Board of Review. 

Decision of the March Board of Review may be appealed by petition to the Michigan Tax Tribunal by July 31 of 

the current year. A July or December Board of Review decision may be appealed to the Michigan Tax Tribunal by 

petition within 30 days of decision. A copy of the Board of Review decision must be included with the petition. 

Michigan Tax Tribunal 

PO Box 30232 

Lansing MI 48909 

Phone: 517-335-9760 

Email: taxtrib@michigan.gov

03/14/2026 

01:23 

PM 

2026 BOARD OF REVIEW DECISION 

FROM 

SWAN CREEK TOWNSHIP 

11415 LAKEFIELD ROAD 

PO BOX 176 

ST. CHARLES, MI 48655 

NAME AND ADDRESS OF OWNER OR PERSON NAMED ON ASSESSMENT ROLL: 

PROPERTY IDENTIFICATION: (Parcel Code required. Property address 

and legal description optional.) 

26-11-3-08-2214-000 

3331 JOHANN DR 

CHAPPLE DEBORAH 

3331 JOHANN DR 

SAGINAW MI 48609 

LOT 14 FRANK JOHANN SUBIDIVISION SEC 08 T1IN R3E 

THIS PROPERTY IS CLASSIFIED 

401 

(RESIDENTIAL-IMPROVED) 

Thank you for attending this years March Board of Review. The Board has reviewed the information you supplied and the data necessary 

to compute your assessment and taxable value. 

The Board has completed their review of parcel number 

26-11-3-08-2214-000 

They have made the following determination based on the information you supplied. 

Board of Review Comments 

POVERETY DENIED - IMCOMPLETE APPLICATION 

| 2026 ORIGINAL ASSESSED VALUE 

92,900 

[2026 "BOARD OF REVIEW" ASSESSED VALUE 

92,900 

| 

(If the above amounts are the same, no revisions have occured) 

2026 ORIGINAL TAXABLE VALUE 

61,693 

2026 "BOARD OF REVIEW" TAXABLE VALUE 

61,693 

2026 PRINCIPAL RESIDENCE EXEMPTION/QUALIFIED AG 

100.0000 

Please feel free fo contact the assessor at the address lisied above or call if you have any questions. 

“Effective March 1, 2013, the Tribunal is no longer able to accept Small Claims letter appeals. Rather, you are required to file a petition to 

initiate a new Smal! Claims appeal. Petition forms are available on this website.” 

http://www.michigan.gov/taxtrib/0,4677,7-187-38254---,00.html

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