25-003903.pdf

Jack A Shoemaker, Petitioner V Township Of Harrison, Respondent · 25-003903-TT

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RECEIVED 

JAN 12 2026 

MICHIGAN TA 

Ce 

STATE OF MICHIGAN 

X TRIBUNAL 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON I, BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

PROPERTY TAX APPEAL ANSWER FORM 

DISABLED VETERANS EXEMPTION 

MTT DOCKET NO. 25-003903 

Section 1: Respondent’s Contact Information 

Unit of Government 

Township of Harrison 

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

38151 L'Anse Creuse 

City or Town: 

State: 

2iP Code: 

Harrison Township 

Mi 

48045 

Telephone nmber poe 

466-1 41 0 

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

dkopp@harrisontownshipmi.gov 

Section 2: Respondent’s Attorney/Authorized Representative’s Contact Information 

First Name: 

ML: 

Last Name: 

Debra 

J 

Kopp 

Firm Name (if any): 

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

38151 L'Anse Creuse 

City or Town: 

State: 

ZiP Code: 

Harrison Township 

Mi 

48045 

Telephone Number: 586-466-1 41 3 

Email Address (do not enter unless you want MTT to send all correspondence via email): 

dkopp@harrisontownshipmi.gov 

Section 3: Subject Property Information: 

Parcel Identification Number: 

17-11-25-128-008 

Section 4: Explain Your Answer to this Appeal

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON I. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

Section 5: Jurisdictional Issues 

Did Petitioner request a disabled veterans exemption by filing an application with the cityftownship? 

Yes 

[mn] No 

List the date the exemption was denied: 

Tax year(s) denied: 

9/8/2023 (per omitted STC petition 154-2023-0423) 

[2022 & 2023 

Signature *required 

3 

Respondgfit 

or CT 

nfative’s Signature: 

of 

mn 

; CZ

STATE OF MICHIGAN 

MICHIGAN STATE TAX COMMISSION 

OFFICIAL ORDER 

Docket Number: 

154-2023-0423 

Issued November 18, 2025 

The State Tax Commission, at a meeting held on November 18, 2025, approved a request pursuant 

to MCL 211.154 to revise the real and/or personal property assessment for the below listed parcel to 

the values indicated. 

B 

Property Owner: 

Parcel Code: 

 17-11-25-128-008 

SHOEMAKER, JACK A; WILLIS, TINA C 

Classification: 

REAL 

36540 UNION LAKE RD #2 

HARRISON TOWNSHIP MI 48045 

County: 

MACOMB 

oad 

CHARTER TWP. OF HARRISON 

Assessing Officer / Equalization Director: 

oi: 

DEBRA J. KOPP 

Village: 

NONE 

38151 L'ANSE CREUSE 

School District: 

 L'ANSE CREUSE PUBLIC SCHOOLS HARRISON TWP., MI 48045-1996 

ORIGINAL 

REQUESTED 

APPROVED 

NET INCREASE 

YEAR 

VALUATION 

VALUATION 

VALUATION 

NET (DECREASE) 

ASSESSED VALUE 

2023 

$0 

$34,900 

$34,900 

$34,900 

2022 

$0 

$28,600 

$28,600 

$28,600 

TAXABLE VALUE 

2023 

$0 

$19,018 

$19,018 

$19,018 

2022 

$0 

$18,113 

$18,113 

$18,113 

The assessor is directed to enter on the assessment roll the net increase/decrease In assessed value and/or 

taxable value for each year, as approved by the State Tax Commission. The officer preparing or having the tax 

roll in his/her possession is directed to enter corrections on the affected tax rolls and to spread the appropriate 

millage rates for each year corrected. 

If this order results in additional taxes being owed, the officer having the tax roll in his/her possession shall, not 

later than 20 days after receiving this order, submit a corrected tax bill, itemized by taxing jurisdiction, to the 

owner of the property. See MCL 211.154 (3) and (4) regarding the applicability of penalty and interest. 

If excess taxes have been paid as a result of an over assessment, a refund of the overpayment shall be made 

by the county treasurer as provided by MCL 211.154 (6). 

This order limits the additional taxes to the amount which was not paid or not associated with the 

disabled veteran exemption, PA 161 of 2013. 

A person to whom property is assessed may appeal the State Tax Commission's determination within 35 days 

of the date of issuance to the Michigan Tax Tribunal. More information on how to file an appeal with the 

Michigan Tax Tribunal can be found at www.michigan.gov/taxtrib or by calling the Michigan Tax Tribunal at 

(517) 335-9760.

: 

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF TREASURY 

RACHAEL EUBANKS 

GOVERNOR 

LANSING 

STATE TREASURER 

September 17 2025 

RE: 154-2023-0423, Charter Twp. of Harrison, Macomb County 

R E CEIVED 

DEBRA J. KOPP, ASSESSOR 

CHARTER TWP. OF HARRISON 

ort - 71 085 

38151 L'ANSE CREUSE 

’ 

HARRISON TWP., MI 48045-1996 

Dear Assessor: 

HARRISON TWP ASSESSING 

The State Tax Commission has received a petition which indicates that the assessment placed on the 

property listed below is believed to be incorrectly reported or omitted according to MCL 211.154. The 

petition requests that the assessment be changed for the year(s) as indicated below: 

Property Class: REAL 

Current 

Requested 

Parcel Code No. 

Year 

Assessed Value 

~~ Assessed Value 

~ 17-11-25-128-008 

2023 

$0 

$34,900 

2022 

$0 

$28,600 

Current 

Requested 

Parcel Code No. 

Year 

Taxable Value 

Taxable Value 

17-11-25-128-008 

2023 

$0 

$19,018 

2022 

$0 

$18,113 

The State Tax Commission will make a determination regarding this requested change at their 

meeting held on 

November 18, 2025 

at 9:30 AM at the Event Center, 2187 University Park 

Drive, Okemos, MI 48864. The meeting will also be conducted virtually with the audio and video link 

posted on the State Tax Commission's website one week prior to the meeting at 

www.michigan.gov/statetaxcommission. 

A concurrence agreeing to this change has not been received. Therefore, you or your representative, 

are invited to attend this meeting to present information in support of your position. Pursuant to STC 

Rule 209.16, any additional supporting written documentation must be received by our office no fater 

than 30 days prior to the meeting date. New documents will not be accepted at the Commission 

meeting. 

If you wish to attend the meeting, please call 517-241-1240 no later than 10 days prior to the meeting 

date. A request to postpone must be submitted to our office in writing 20 days prior to the meeting 

date and may only be obtained for cause. Questions regarding this matter may be directed to the local 

assessor, 517-335-4410 option 6 or Treas-154petitions@michigan.gov. Petition status and additional

Michigan Department of Treasury 

627 (Rav. 11-17), Page 1 of 2 

L-41 54 

Assessor or Equalization Director's Notice of Property 

Incorrectly Reported or Omitted From Assessment Roll 

a 

This form Is Issued under authority of Section 211,154, MCL. Filing Is mandatory, 

PART 1: ASSESSOR/EQUALIZATION DIRECTOR SECTION 

ASSESSOR/EQUALIZATION DIRECTOR INFORMATION (Type or Print Legibly) 

* 

. 

-- 

Name of Assessor or Equalization Director 

Telephone Number 

E-mall Address 

Debra J. Kopp 

(586) 466-1413 

dkopp@harrisontownshipmi.gov 

Mailing Address (Number, Street, PO Box) 

Clty 

State 

ZIP Code 

38151 Lanse Creuse 

Harrison Township 

Mi 

48045 

FROPERTY. 

AND ASSESSMENT ROLL INFORMATION ~~ 

~~... 

 .. 

.. 

.o-. 

. 

Lo 

Name(s) of Property Owner(s) 

Jack A. Shoemaker and 

Tina C. Willis 

Owner's Malling Address (Number, Street, PO Box) 

City 

Stale 

ZIP Code 

36540 Union Lake Rd #2 

Harrison Township 

Ml 

48045 

County Where Property is Located 

Name of Lacal Assessing Unit 

Village Name (if applicable) 

Macomb 

Harrison Township 

Parcel Code 

Name of School District Where Property Is Located 

_ 17-11-25-128-008 

Lanse Creuse Public Schools 

50140 

Property Classification 

Real Resldential 

[| Real Agricultural 

[| Personal Industrial 

[| Personal Residential 

[| Real Industrial 

| Real Developmental 

(| Personal Commerclal 

[| Personal Agricultural 

[] Real Commercial 

[] Real Timber-Cutover 

~~ [_| Personal Utiity 

[special Roll (PA 198, PA 255, PA 189) 

Property Description (if omitted from the roll, legal description must be provided) 

f 

HIDDEN OAKS CONDO UNIT 8 BLDG A 

MCCSP #32 

Commonly Known As: 36540 Union Lake #8 

REASON FOR THIS NOTICE 

y 

5 

43 

FC 

ENR 

PE 

The Assessor or Equalization Diractor must provide a detalled explanation for requesling this Change. ‘Attach an addifonal page If necessary. 

Property owner, Jack A. Shoemaker, applied for and was granted a Disabled Veterans Exemption by the March, 2023 

Board of Review for thls parcel. On July 10, 2023 Mr. Shoemaker purchased another home, claimed It as his principal 

residence and applied for and was granted a Veterans Exemption at his new location. Since this non-homestead parcel 

no longers qualifies for the Veterans Exemption this property should be added back to the Tax Roll as of 7/10/2023. 

Additionally, this property has a Joint ownership and does not qualify for a Veterans Exemption. See attached deed. 

DER TNT 

ASSESSED VALUE... "Tr 

[ wi” 

TAXABLE VALUE ....+.. 

Year(s) for Which Noti 

Assessed Value 

Requested 

Taxable Value 

Requested 

was Given 

on Assessment Roll 

Assessed Value 

on Assessment Roll 

Taxable Value 

2023 

0 

34,900 

0 

19,018 

2022 

0 

28,600 

0 

18,113 

REAL AND PERSONAL'PROPERTY INFORMATION (Quistion 1 Personal Propéity only) is 

++ 

© 

~ <i 

har 

LH 

1. 

Did the owner of the property complete and deliver a Form 832 (L-4175), Personal Property Statement, or Form 5278, Eligible Manufacturing 

Personal Property Combined Document, for each year that this notice covers that was: 

(| Timely Filed? (Accepted as filed and used in determining the assessment that was confirmed by the Board of Review?) 

[| Estimated/Not Filed? If estimated or not filed, Indicate the year(s): 

2. 

Is this property assessed on the Industrial Facillies Tax Roll, the Commercial Facliities Tax Roll, the Technology Park Faciliies Roll, the

_ 

627,Page2of2 

17-11-25-128-008 

Parcel Code from Page 1 

INSTRUCTIONS FOR ASSESSORIEQUALIZATION DIRECTOR 

. 

NOTICE: THIS FORM WILL NOT BE PROCESSED IF THE FOLLOWING DOCUMENTATION IS NOT PROVIDED: 

Each form must include calculations showing how the proposed revision in assessed and taxable value was calculated. 

Personal Property: Include a copy of the original Form 632 (L-4175), or Form 5278, and a copy of the amended Form(s). 

Real Property: Include a copy of the record card showing that property was omitted from the record card, or that the property was 

included on the record card when it did not exist, or that an item on the record card was incorrect. 

For a complete list of items needed to process your application, review the “MCL 211,154 Checklist” online at 

www.michigan.gov/154 petitions. 

The State Tax Commission's jurisdiction under MCL 211,154 is limited to correcting assessments for the current assessment year (the 

year of discovery and disclosure to the State Tax Commission) and two immediately preceding years. Although you must present a 

copy of this form to the property owner for concurrence or disagreement, you may also immediately submit a second copy of this form, 

without the owner's concurrence or disagreement, to tha State Tax Commission. Your failure to do so by December 31 of the current 

calendar year may affect the Commission's jurisdiction to consider all of the assessment years that the Assessor or Equalization 

Director included on this form, 

PART 2; PROPERTY OWNER SECTION 

OWNER'S BONCURRENCE OR DISAGREEMENT 

=: 

TES 

RA 

THIS SECTION SHALL BE COMPLETED BY THE PROPERTY OWNER AND THE SIGNED FORM AND ANY ATTAGHMENTS 

RETURNED TO THE ASSESSOR. 

[1 1 AGREE with this request for corrected Assessed Value and/or Taxable Value. 

[I 

1 DO NOT AGREE with this request for corrected Assessed Value and/or Taxable Value. (The owner who checks this box must 

submit an explanation below for not concurring with this request.) 

DWNER'S EXPLANATION FOR NON-GONCURRENCE (attach additional pages as necessary) 

for woul \ERES 

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OWNERSHIP OF PROPERTY 

Cl 

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Ti 

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oF 

Did the property that |s Indicated In this form change ownership during the ime pre starting with the earlfest prvr——— a change 

is being requested, up to the present? 

Yes 

[One 

If Yes, insert the date the ownership hangad; 20 LS 

BROBERTY 

OWNER CERTIFICATION = 

~~" 

7 Fan. 

© 

TT 

1 hereby cortlly that all the Information contelned within, and attached {o, ts apploation Is true and accurate to the best of my 

knowledge, information and belief, 

Property 

or Signature 

Date 

"ALK Several 

9-16-23 

i Number 

E-mall Address 

EBL 530-158

Charter Township of Harrison 

Assessing Department 

Email: assessing@harrisontownshipmi.gov 

Phone: (586)466-1410 

Fax: (586)465-2618 

VIA CERTIFIED MAIL 

September 8, 2023 

Jack A. Shoemaker 

36540 Union Lake Rd. #2 

Harrison Township, MI 48045 

Re: 

Disabled Veterans Exemption 

36540 Union Lake Rd. #8 

Parcel: 17-11-25-128-008 

Dear Mr. Shoemaker: 

We are sending this letter to notify you that we are asking the State Tax Commission to restore the 

assessed and taxable values to the property referenced above to the 2022 and 2023 tax rolls for the 

following reasons: 

1. 

The property referenced above that was granted a Disabled Veterans Exemption for 2023, but as 

of July 10, 2023, no longer qualified as your principal residence; 

2. 

It came to our attention that the property was in joint ownership and does not qualify for the 

exemption. (Please see the enclosed guidelines issued by the Michigan State Tax Commission 

regarding other co-owners). 

Please review the enclosed form (L-4154), then complete “Part 2: Property Owner Section”. This 

document must be returned to the Assessor’s Office no later than Monday, September 18, 2023. 

If you have any questions or concerns, please do not hesitate to contact our office.

Michigan State Tax Commission 

Disabled Veterans Exemption 

Frequently Asked Questions

-1am a disabled veteran who is a lifelong Michigan resident. In addition to my 

primary residence, 

| also own a summer home “up north”. Are both of my homes 

eligible for the exemption? 

No. MCL 211.7b is specific that the property must be owned and used as a homestead. 

The statute does not provide for receiving more than one Disabled Veterans Exemption. 

If 

| own stock or 

a membership in a residentlal cooperative, does my unit qualify 

for the exemption? 

No. A membership or stock ownership in a cooperative is the ownership of an interest in 

a corporation, not the ownership of real property. 

If | have a life estate, life lease, or “lady bird” life interest in my residence and the 

remainder interest is held by others, can my property qualify as my homestead? 

Yes. If the other requirements for receiving the exemption are satisfied, then property 

occupied under a life estate, life lease, or “lady bird" life interest can qualify as the 

disabled veteran's or unremarried surviving spouse's homestead. 

If 

my home is in a joint tenancy or there are other co-owners, am | eligible for the 

~ exemption? 

LS 

| 

No. A joint tenancy is a form of concurrent ownership wherein each co-tenant owns an 

x undivided share of property and the surviving co-tenant has the right to the whole 

- 

estate. A co-ownership is a fractional ownership interest, with part ownership held by 

thers. MCL 211.7b does not provide for a partial exemption in the situation where you 

area partial owner of a property. 

A 

Ownership of the homestead by the disabled veteran with his or her spouse, as tenants 

by the entireties, is not disqualifying. 

If 1 am disqualified from receiving the exemption because there are other joint 

tenants or co-owners, can | remove the other owners from the deed and reapply 

for the exemption in a subsequent year? 

Yes. If a disabled veteran or unremarried surviving spouse applied for and was denied 

the exemption due to other joint tenants or co-owners, the disabled veteran or 

unremarried surviving spouse can execute a new deed that removes the other owners. 

However, once the exemption is denied by a Board of Review in the current year, it 

cannot be resubmitted and granted to another Board of Review during that same year.

age 

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RECD H00HB £0 * | 3AUGOSPH0300 

ry) 00% 

GHIGRIT bids rl 

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Macomb Coun 

Ei 

Carmella Cope 

t Clerk/Register of Sh 

(wot A TRANSFER )=*™ 

QUIT CLAIM DEED 

KNOWALL PERSONS By These presents: That TMA Cp) lis 

FEATINR 

whose addresses usa 

& Hort iat 

LU! 

£093 

Stotean fot 

Quit 

to 

{p ce 

A Ho eMALER 

4 

TINA 

C, 

i]s 

——— 365W Uulod ake r gd Has al 

Msgr 

the following described premises sltvated In the City of 

, Counly of , State of 

“a0, Tl, 

MacomP, mes 9 An 

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for the full conslderation of; ono‘ °° 

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STATE OF 

Mick gan 

COUNTYOF 

 (V\ Arc.om 

The foregoing Instrument wes acknowledged beforamaon 

~~ q- 

2013, 

| 

| 

PrintNeme: 

K2A/| 

. 

RENEE I. BOND 

Notary Public 

7; #/4/& county, Michigan 

NOTARY FUEL STE OF 

rack (ti piras: Bafor fac) ? iE 

iman 

Drafad by: 

Relum to: 

nek 

|. Stoeme et 

3118218 

Page 1 of 1 

/’S 40 

0008 60

01/11/2024 10:14 AM 

Fees: $30.00 

RECD COE 00° 24JANL 111009 

Anthony G. Forlinl, Clerk/Register of Deeds 

L 

0 % 

Macomb County, Mi 

ISTE 

— 

202400003200 L: 29439 P: 410 Pages: 2 {/b 

9 

QUIT CLAIM DEED 

KNOW ALL MEN BY THESE PRESENTS THAT: Tina C. Willis fka Tina C. Shoemaker and Jack A. 

Shoemaker 

whose address is: 11524 Short Street, Warren, Michigan 48093 and 36540 Union Lake Road, No 2, 

Harrison Twp, Michigan 48045 respectively 

‘Quit Claims to: Jack A. Shoemaker 

whose address is: 36540 Union Lake Road, No 2, Harrison Twp, Michigan 48045 

The following described premises situated in the Township of Harrison, County of Macomb and State of 

Michigan to wit: 

Apartment 8 of Hidden Oaks Condominium, according to the Master Deed thereof, as recorded 

in 

Liber 2254, pages 127 to 148, inclusive as amended, Macomb County Records and designated as 

Macomb County Condominium Subdivision plan No 32, together with rights in general common 

elements and limited common elements, as set froth in the above Master Deed and exhibits 

attached thereto and as described in act 229 of the Public Acts of 1963 as amended, which is 

replaced by Act 59 of the Public Acts of 

1978 as amended. 

Subject to easements, right of way, restrictions, and reservations of record. 

Commonly known as: 36540 Union Lake Road, Apartment 

8, Harrison Twp, Michigan 48045. 

Tax ID No: 

Together with all and singular the tenements, hereditaments and appurtenances thereunto belonging or in 

anywise appertaining for the sum of One ($1.00) dollar. This transaction is, exempt from County Transfer 

Tax pursuant to MCLA 207.505(a) or MSA 7.456(a) and State Transfer Tax pursuant to MCLA 

207.526(a) or MSA 7.456(5)(a). 

¥ Dated this 22" besa December 

203 

| 

Signed: 

ina C. Willis fka Tina C. Shoemaker

. 

IAPR 

) TER, pt bcos 

7 

. 

' 

202300081781 

L: 29216 P: 668 Pages: 2 

MACOMB COUNTY, MI 

/ ir: 

mn b nl 

07/19/2023 10:27 AM 

Fees: $35.00 

Anthony G. Farlinl, Clerk/Register of Deeds 

. 2023 JUL 18 11:42 AM 

VY) 2% 

Macomb County, MI 

E-Recorded 

This Is the cerifly that according to the County 

Treasurer's records that there ara no tax llens 

on thls property and that the taxes are pald 

MICHIGAN REAL ESTATE TRANSFER TAX 

forfive years prior to the date on this instrument 

) 

leasomb Coury Fax ramp ages 

except____ NO: 11820, LAWRENCE ROCCA 

4 

:27:, 

Macomb County Treasurer BY CT 

[ /) 

Recelpti# R-23-48658 L: 28218 P: 668 

This certfication does notinclude cument taxes now 

— 

State Tax: $800.00 County Tax: $182.00 

being collected. Date: 07/18/2023 

WARRANTY DEED 

(Sratuiory Form - Individual) 

I. 

1 

Know all persons by these presents; that, Windyslaw Olech, a single man, and Bozena Kiypyehrn single woman 

whose address Is 36540 Unlon Lake Road, 2, Harrison Township, Mi 48045 

Conveys and warrants to Jack A. Shoemaker, a single man 

whose address is 36540 Union Lake Road, 8, Harrison Township, M) 48045 

the following described premises situated in Havrison Township, County of Macomb, State of Michigan to-wit: 

See Attached Exhibit A 

Cotimonly known as: 36540 Union Lake Road, 2, Harrison Township, MI 48045 

Parcel 1.D, Number: 17-11-25-128-002 

For the full consideration of ONE HUNDRED TWENTY THOUSAND AND 00/100, $120,000.00 

Subject to existing building and use restrictions, easements, and zoning ordinances, if any. 

Dated: 10th day of July, 2023 

Wladyslaw Olech / 

4 y 

Dozens 

or 

wt, Wsfommey-3u-" 

KBozena Klypych 

7 

Tas 

» by Wiladyslars 

NAY 

Far ja 

Facer 

Stateof 

JVVE 

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7 

hi +. 

County 

of * Vl sons Yuri FEE ars Stavps 

a 

9a 

14 

On this 10th 

day of July, 2023, before me personally appeared Windyslaw Olech, a single man, and Bozena 

Klypyehy'a 

single woman, known to me to bs the person(s) described in and who executed the foregoing instrument 

and acknowledged that they executed same as their free act and deed. 

ELIZABETH J. JARVIS 

NOTARY PUBLIC, STATE OF MJ 

COUNTY OF MACOMB 

MY COMMISSION EXPIRES Feb 

8, 2008 

Notery 

PUblic 

. 

NCTRGINCOWNIYOF 

Mt Acomf 

‘Corffty, Michigan

Michigan Department of Treasury 5107 

{12:13) 

State Tax Commission Affidavit of Disabled Veterans Exemption 

Issued under authority of Public Act 161 of 2013, MCL 211.7b. Filing is mandatory. 

p 

INSTRUCTIONS: This form is to be used to apply for an exemption of property taxes under MCL 211.7b, for real property used and 

% ~ owned as a homestead by a disabled veteran who was discharged from the armed forces of the United States under honorable 

onditions or his or her unremarried surviving spouse. The property owner, or his or her legal designee, must annually file the Affidavit 

with the supervisor or assessing officer after December 31 and before the Tuesday following the second Monday in December. 

OWNER INFORMATION (Enter information for the disabled veteran or unremarried surviving spouse) 

Owner's Name 

Owner's Telephone Number 

SHOEMAKER. JACK A 

S86 

530-8138 

Owner's 

Mailing 

Add 

a 

3eSlO Toon Cale RD #8 

State 

Zip 

Code 

/ 

ae 

vi sew Twp. 

mi 

dolls 

LEGAL DESIGNEE INFORMATION (Complete if applicable) 

eu 

Legal Designee Name 

RECEW [==] 

Daytime Telephone Number 

Mailing Address 

- 

- 

~~ 

- 

wot 

- 

? 

i= 

022 

City 

State 

G Zp Code 

ESSN 

LoanrISON TWP pss 

HOMESTEAD PROPERTY INFORMATION 

(Enter information for the property in which the exemption is being claimed) 

City, Township or Village (Check the appropriate box and provide the name) 

ilaees sow 

CL] cw 

PA, rownstip 

[] 

vilage 

County 

Name of the Local School District 

School District Description 

MACOMB 

50140 

L ANSE CREUSE PUBLI 

Parcel Identification Number 

Date the Propety was Acquired (MM/DD/YYYY) 

1 17.11-25-128-008 

Homestead Property Address 

36540 UNION LAKE #8 

City 

State 

Zip Code 

HARRISON TOWNSHIP 

Mi 

48045 

ACKNOWLEDGEMENT (Check all boxes that apply) 

| am a disabled veteran, or the legal designee of the disabled veteran, who was discharged under honorable conditions from the armed forces of the 

United States of America with a service connected disability. 

| am the unremarried surviving spouse, or the legal designee of the unremarried surviving spouse, of a disabled veteran who was discharged under 

honorable conditions from the armed forces of the United States of America with a service connected disability. 

X] 

1am a Michigan resident. 

F( 

1 own the property in which the exemption is being claimed and it is used as my homestead. Homestead is generally defined as any dwelling with its land 

and buildings where a family makes its home. 

AFFIRMATION OF ELIGIBILTIY (Check the appropriate box and provide a copy of the required documentation 

+71 

The disabled veteran has been determined by the United States Department of Veterans Affairs fo be permanently and totally disabled as a result of 

xX 

military service and entitled to veteransd benefits at the 100% rate (must altach a copy of the letter from the U.S. Department of Veterans Affairs). 

The disabled veteran is receiving or has received pecuniary assistance due to disability for specially adapted housing (must attach a copy of the certificate 

[] 

from the U.S, Department of Veterans Affairs).

““WnTgEn Department of Treasury 5107 

(1243) 

State Tax Commission Affidavit of Disabled Veterans Exemption 

Issued under authority of Public Act 161 of 2013, MCL 211.7b. Filing is mandatory. 

INSTRUCTIONS: This form is to be used to apply for an exemption of property taxes under MCL 211.7b, for real property used and 

~~ nwned as a homestead by a disabled veteran who was discharged from the armed forces of the United States under honorable 

»nditions or his or her unremarried surviving spouse. The property owner, or his or her legal designee, must annually file the Affidavit 

with the supervisor or assessing officer after December 31 and before the Tuesday following the second Monday in December. 

OWNER INFORMATION (Enter information for the disabled veteran or unremarried surviving spouse) 

Owner's Name 

Owner's Telephone Number 

SHOEMAKER. JACK A 

Owner's Mailing Address 

11524 SHORT 

City 

State 

Zip Code 

WARREN 

Mi 

48093 

LEGAL DESIGNEE INFORMATION (Complete if applicable) 

Legal Designee Name 

RECEIV = 8] 

Daytime Telephone Number 

Mailing Address 

FEB 

1 6 2023 

City 

State 

Zip Code 

HARRISON TWP. ASSESSING 

HOMESTEAD PROPERTY INFORMATION 

(Enter information for the property in which the exemption is being claimed) 

City, Township or Village (Check the appropriate box and provide the name) 

[Jey 

[] Township 

[| 

vilage 

County 

Name of the Local School District 

School District Description 

MACOMB 

50140 

LANSE CREUSE PUBLI 

Parcel Identification Number 

Date the Propety was Acquired (MM/DD/YYYY) 

' 17-11-25-128-008 

.omestead Property Address 

36540 UNION LAKE RD #8 

City 

State 

Zlp Code 

HARRISON TOWNSHIP 

Mi 

48045 

ACKNOWLEDGEMENT (Check all boxes that apply) 

Iam a disabled veteran, or the legal designee of the disabled veteran, who was discharged under honorable conditions from the armed forces of the 

United States of America with a service connected disablity. 

Iam the unremarried surviving spouse, or the legal designee of the unremarried surviving spouse, of a disabled veteran who was discharged under 

[] 

honorable conditions from the armed forces of the United States of America wilh a service connected disability. 

| am a Michigan resident. 

1 own the property in which the exemption is being claimed and it is used as my homestead. Homestead is generally defined as any dwelling with its land 

and buildings where a family makes Its home. 

AFFIRMATION OF ELIGIBILTIY (Check the appropriate box and provide a copy of the required documentation 

The disabled veteran has been determined by the United States Department of Veterans Affairs to be permanently and totally disabled as a result of 

military service and enlitled to veleransi benefits at the 100% rate (must altach a copy of the lelter from the U.S. Department of Veterans Affalrs). 

The disabled veteran is receiving or has received pecuniary assistance due to disability for specially adapted housing (must altach a copy of the certificate 

from the U.S. Department of Veterans Affairs).

E

Assessor’s Office 

38151 Lanse Creuse 

"Harrison Township, MI 48045

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