tax denial.pdf

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Michigan Department of Treasury 

4075 (Rev. 08-23) 

Notice of Denial of Principal Residence Exemption 

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 County Treasurer or Equalization Director, or follow the appeal procedures specified 

By % 

: 

below. For more information regarding the Principal Residence Exemption (PRE), please review the PRE guidelines at www.michigan. 

i 

RX 

gov/pre. 

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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 

Townshi 

- 

003-026-023-00 

Xl 

Dun 

Attica 

Lapeer 

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

2443 Atwell Rd Attica MI 48412 

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

6. Owner's Last Four Digits of Social Security Number | 7. Owner's Daytime Telephone Number 

Eric Parsons 

XXX-XX- 

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

9. Co-Owner's Last Four Digits of Social Security Number | 10. Co-Owner's Daytime Telephone Number 

XXX-XX- 

Bat a 

/ 

11. Mailing address if different than property address (street or RR#, city, state, ZIP Code) 

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

1 a. The owner is not 

a Michigan resident. 

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

I: c. The person claiming the exemption is not the owner. 

= d. The person claiming the exemption, claimed or was granted, a substantially similar exemption in another state. 

[X] e. other. Failure to Respond 

13. Claim Denied for Calendar Year(s): 

14. Percentage Adjusted to: 

(see instructions) 2021, 2022. 2023 

| 

0 o, 

| PART 2: CERTIFICATION 

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15. Name of the County Treasurer or Equalization Director (Print or Type) 

Dana M. Miller 

| 16. Signature of County Treasurer or Equalization Director 

SAS 

a LAS Xl Colinty Treasurer 

17. Date 

ERsue 2 

Za) 

Bis 

/ 

V/A 

Equalization Director 

x7 / 

: Y) 2k 

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18. Address and Telephéne Numbler of County Treasurer or Equalization Director 

H 

255 Clay St Lapeer MI 48446 

(810) 667-0239 

19. Email Address of County Treasurer or Equalization Director 

Treasurer@lapeercounty.org 

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.