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26-000342 Petition.pdf

Brandon A Guess, Petitioner V City Of Detroit, Respondent · 26-000342-TT

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Page 1

RECEIVE 

pm, 

. 

AR 

FEB 25 2025 

PICHIGAN TAX TRIBUNAL 

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON I. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

e 

PROPERTY TAX APPEAL PETITION FORM 

PRINCIPAL RESIDENCE EXEMPTION / QUALIFIED AGRICULTURAL EXEMPTION 

Pursuant to Michigan Tax Tribunal Rule (TTR) 279, you MUST submit a copy of the notice giving rise to the appeal (e.g. 

Notice of Denial or Board of Review Decision) with this Small Claims Petition, if applicable. If you do not submit this 

document, you may be placed in default. 

Section 1: Petitioner’s Contact Information 

FirstName 

Ml. 

Last Name/Company Name 

can QOL P.O. Box or Rural Rqjite 

A 

G uess 

GAY muerness, ST 

City or Town 

State 

ZIP Code 

De 21h 

MIL AYIA 

Telephone Number 

CARYN 

\ Ha 

E-mail Addrdss (do not enfer unless 

you want MTT to send all correspondence via e-mail) 

(Ze Greair\\c 

LE amai\ cam 

Section 2: Petitioner’s AttorneyAuthorized Representative’s Contact Information 

First Name 

Last Name 

Fax Number 

Firm Name (if any) 

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

City or Town 

State 

ZIP Code 

Telephone Number 

Fax Number 

E-mail Address (do not enter unless you want MTT to send all correspondence via e-mail)

Page 2

Br Viel 

{ 317 

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON I. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

ks 

Section 3: Subject Property Information 

Parcel Identification Number: 

DEO ARAN 

How many 

If 

you ake appealing more than one parcel, are they contiguous or adjoining? 

parcels are you 

Yes* 

No** 

appealing? 

*If yes, use a multiple parcel form for Information regarding any contiguous parcels. 

*f no, you must file separate appeals for each non-contiguous or non-adjoining parcel ar you will be defaulted, 

Property Address (No., Street, City, ST, ZIP) 

[If multiple, list first proper 

Saddress] 

1409" Enperness SF Deda 

MT R20 

Taking Authority (City or Township) 

Qe beni 

“Wayne 

Classification of Property: 

Agricultural 

Commercial 

Industrial Rest 

Timber-Cutover 

Developmental 

Utility 

(check one) 

[|| 

a 

(} 

OJ 

[] 

Section 4: Check which of the following 

you are appealing 

I Residence Exemption 

[i 

| Qualified Agricultural Exemption 

Section 5: Explain the Reason for this Appeal 

I mid Ye Princip Pesidence. 

Exemption (BRE) 

we DecuE + rece Vel my wa \aIR. The, 

Hie Ce 

yb Sra 

|W 

We 

\ 

\ihed\ WC Cg BY 

uri 

PAREN 

de SUN 

ond) 

my wit Yhe Poser 

. 

Tord ctor, Deh 

hl \ Rua na, 

Well bt 

Er 

it 

best 

Issues 

OF SWSpIIn0 ng Aly 

@ 

List the tax year(s) denied: 

2D) DONA 2025 DONS 

Indicate who denieg/the exemption uplier appeal:

Page 3

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON |. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

¢ 

Fee Information 

A fee of $25.00 is required for the filing of this appeal unless you possess a Principal Residence Exemption of at least 50% at the time of 

the filing of this petition, 

Signature *required 

Petitioperor 

Attor: 

"CC 

ed 

Rgpresentative’s Signature: 

Ist Drader ed) 

7

Page 4

Section 5: Declarations. This section asks you specific questions about the property, your funding, and your past financial history. 

5a, About this\Propertyand Your Money: for this Loan 

If YES, have you had an ownership interest in another property in the last three years? 

@NOo 

OVYES 

If YES, complete (1) and (2) below: 

(1) What type of property did you own: primary residence (PR), FHA secondary residence (SR), second home (SH), or 

investment property (IP)? 

(2) How did you hold title to the property: by yourself (S), jointly with your spouse (SP), or jointly with another person (0)? 

B. 

If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property? 

@©NO 

OVYES 

C. 

Are you borrowing any money for this real estate transaction (e.g., money for your closing costs or down payment) or obtaining 

any money from another party, such as the seller or realtor, that you have not disclosed on this loan application? 

@NO 

OYES 

If YES, what is the amount of this money? 

[ 

D. 

1. Have you or will you be applying for a mortgage loan on another property (not the property securing this loan) on or before 

@NO 

OVYES 

closing this transaction that is not disclosed on this loan application? 

2. Have you or will you be applying for any new credit (e.g., installment loan, credit card, etc.) on or before closing this loan that 

@No 

OYE 

is not disclosed on this application? 

E. 

Will this property be subject to a lien that could take priority over the first mortgage lien, such as a clean energy lien paid through 

your property taxes (e.g., the Property Assessed Clean Energy Program)? 

@no 

 Oves 

F.. 

Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application? 

@nNo 

OVYEes 

Are there any outstanding judgments against you? 

@nNo 

OVYES 

Are you currently delinquent or in default on a Federal debt? 

. 

@©NOo 

OVYEs 

I. 

Are you a party to a lawsuit in which you potentially have any personal financial liability? 

@No 

OVYES 

J. 

Have you conveyed title to any property in lieu of foreclosure in the past 7 years? 

@NO 

OVYES 

K. 

Within the past 7 years, have you completed a pre-foreclosure sale or short sale, whereby the property was sold to a third party 

ONO 

OVES 

and the Lender agreed to accept less than the outstanding mortgage balance due? 

L. 

Have you had property foreclosed upon in the last 7 years? 

@NOo 

OVYES 

M. 

Have you declared bankruptcy within the past 7 years? 

If YES, identify the type(s) of bankruptcy: 

[1 chapter 7 

(I Chapter 11 

[J Chapter 12 

[J Chapter 13 

eno 

Oo ji]

Page 5

4d! Gifts.or Grants You Have Been Given or: Will Receive for this Loan 

Bd Does 

not apply 

Include all gifts and grants below. Under Source, choose from the sources listed here: 

+ Community Nonprofit 

+ Federal Agency 

« Relative 

+ State Agency 

* Lender 

+ Employer 

+ Local Agency 

+ Religious Nonprofit 

+ Unmarried Partner 

+ Other 

Section 5: Declarations. This section asks you specific questions about the property, your funding, and your past financial history. 

5a. About this Propertyand Your Money for this Loan 

0 

ma 

sid 

If YES, have you had an ownership interest in another property in the last three years? 

E 

ONO 

OYES 

If YES, complete (1) and (2) below: 

(1) What type of property did you own: primary residence (PR), FHA secondary residence (SR), second home (SH), or 

investment property (IP)? 

(2) How did you hold title to the property: by yourself (S), jointly with your spouse (SP), or jointly with another person (0)? 

B. 

If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property? 

@no 

Oves 

C. 

Are you borrowing any money for this real estate transaction (e.g., money for your closing costs or down payment) or obtaining 

any money from another party, such as the seller or realtor, that you have not disclosed on this loan application? 

@©NO 

OVYES 

If YES, what is the amount of this money? 

. 

S$ 

D. 

1. Have you or will you be applying for a mortgage loan on another property (not the property securing this loan) on or before 

@nNO 

OVES 

closing this transaction that is not disclosed on this loan application? 

2. Have you or will you be applying for any new credit (e.g., installment loan, credit card, etc.) on or before closing this loan that 

@NO 

OVYES 

is not disclosed on this application? 

Will this property be subject to a lien that could take priority over the first mortgage lien, such as a clean energy lien paid through 

ONO 

OVYES 

your property taxes (e.g., the Property Assessed Clean Energy Program)? 

5b. About Your Finances 

] 

F. 

Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application? 

@NO 

OVYES 

G. 

Are there any outstanding judgments against you? 

@no 

OYE 

H. 

Are you currently delinquent or in default on a Federal debt? 

@©NO 

OVYES 

I. 

Are you a party to a lawsuit in which you potentially have any personal financial liability? 

@©NO 

OVYES 

J. 

Have you conveyed title to any property in lieu of foreclosure in the past 7 years? 

@NOo 

 OVES 

K. 

Within the past 7 years, have you completed a pre-foreclosure sale or short sale, whereby the property was sold to a third party 

©NO 

OVES 

and the Lender agreed to accept less than the outstanding mortgage balance due? 

L. 

Have you had property foreclosed upon in the last 7 years? 

@NOo 

 OVES 

M. 

Have you declared bankruptcy within the past 7 years? 

ONO 

®YES 

If YES, identify the type(s) of bankruptcy: 

Chapter 7 

(J Chapter 11 

(J Chapter 12 

[J Chapter 13

Page 6

CLOSING WORKSHEET 

Investor: GINNIE MAE 

[Lender: PRIMELENDING, 

A PLAINSCAPITAL COMPANY 

Loan Program: 101271 

Type of Loan: 

Purpose of Loan: 

FHA 30 YR FIXED 

CJ Conv XIFHA 

XJ Purchase (J Cash-Out Refi. [J No Cash-Out Refi. 

Ova ORD 

C1 Construction Only (J Construction/Perip 

[J] 

Amort: 0d Fixed [J ARM 

New Construction: [J Yes XI No 

Repayment Options: (Interest Only 

[1 Balloon 

Cl 

Buydown 

MERS # 

BORROWER/SELLER INFORMATION 

Program Type: 

3 Conforming (C) Non-Conforming 

Borrower 

First Name 

Middle Name 

Last Name 

Suffix 

1st 

BRANDON 

ALEXANDER 

GUESS 

2nd 

DEBORAH 

KING 

Phone: 

IDON 

ALEXA 

ND 

DE 

RD 

LF 

Street Address 

City 

County 

_ 

a 

ip 

Mailing: 16905 INVERNESS 

ST 

DETROIT 

WAYNE 

MI 

48221-3303 

us 

Property: 16905 INVERNESS 

ST 

DETROIT 

WAYNE 

MI 

48221-3303 

Bl AKA: 

B2 AKA: 

BRANDON A GUESS 

DEBORAH ANN KING 

SR 

BRANDON GUESS 

DEBORAH A KING 

DEBORAH ANN 

DEBBIE KING 

DEBORAH A GREEN 

DEBORAH 

A KING 

SR 

DEBRA KING 

VA Relative Name: 

Address: 

Seller 

First Name 

Middle Name 

Last Name 

Ist 

VICKIE 

WELINGTON 

2nd 

CALVIN 

H 

WELLINGTON 

Builder: 

Loan Processor: REBECCA PETERSON 

Loan Closer: KIMBERLY VERSER 

Loan Officer: MATTHEW RODEGHIER 

Closer Phone: (972) 

733-6218 

Closer Fax: (866) 

797-6722 

Closer Email: 

KIMBERLY .VERSER@PRIMELENDING.COM 

0 pUD [1CONDO 

[Name: 

PUD Declaration: 

RIDERS 

[] Adjustable Rate 

[CI Balloon 

Ova 

[J Condo 

“[3PUD 

[Second Home 

[J 1-4 Family 

[Biweekly 

Cl Other(s): 

TITLE/ESCROW INFORMATION 

Title Company: ABSTRACT TITLE INC 

Address: 1900 W BIG BEAVER RD 201 

City: TROY 

State: MI 

[Zip: 48084 

Title Officer 

Name: DIANE HENDRICKS 

Phone: (586) 

751-4500 

Fax: (248) 

643-4501 

Escrow Co.: ABSTRACT TITLE INC 

Address: 1900 

W BIG BEAVER RD 

201 

City: TROY 

State: MI 

[Zip: 48084 

Escrow Officer: DIANE HENDRICKS 

Phone: (586) 

751-4500 

Fax: (248) 

643-4501 

Trustee: 

Address: 

[City: 

[State: 

Zip: 

Title Policy 

CI3R and 5 

[16 (ARMS) 

[]4 (Condo) 

16.2 (Neg Amort) 

05 (PUD) 

Endorsements 

$8.1 (Environ) 

[J Location 

Cl Comprehensive 

X Other: 9 

Prelim Date: 

[Escrow 

[Tax Message: 

[Schedule B Items: 

Parcel ID(s] 

ASSIGNMENT/PAYMENT INFORMATION 

Assignee Name: 

Address: 

ie 

[State: 

[Zip: 

Assignment Date: 

Assign. Loan 

[Phone: 

Assign, Officer: 

Assign. Title: 

Corp. Officer: 

Title: 

Corp. Officer: 

Title:

Page 7

3 

a 

. 

This form is a statement of final loan terms and closing costs. Compare this 

Closi ng Disclosure 

document with your Loan Estimate. 

Closing Information 

Transaction In 

Loan Information 

Date Issued 

10/04/2021. 

~ Borrou 

| 

DON 

ALEXAI 

S 

LoanTerm 

30 years 

Closing Date 

10/04/2021 

19477 CHAPEL ST. 

Purpose 

Purchase 

Dishursement Date 

10/04/2021 

Suir 

Pils 

quar 

Product 

FIXED RATE 

Settlement Agent 

ABSTRACT TITLE INC 

16905 INVERNESS ST 

Loan Type 

[J Conventional XI FHA 

File # 

DETROIT, Mi 48221 

Ova 0 

Property 

16905 INVERNESS ST 

Lender 

PRIMELENDING, A PLAINSCAPITAL 

Loan ID # 

DETROIT, MI 48221-3303 

COMPANY 

MIC # 

Sale Price 

$103,000 

(Vemmans 

Can this amount increase after closing? 

Loan Amount 

$101,134 

- 

NO 

Interest Rate 

3.875% 

NO 

Monthly Principal & Interest 

$475.57 

NO 

See Projected Payments below for your 

Estimated Total Monthly Payment 

Does the loan have these features? 

Prepayment Penalty 

NO 

Balloon Payment 

oC 

NO 

Projected 

Pa 

Payment Calculation 

Years 1-30 

Principal & Interest 

$475.57 

Mortgage Insurance 

+ 

69.83 

Estimated Escrow 

Amount can increase over time 

+ 

Te 

305.08 

Estimated Total 

Monthly Payment 

$85 0.48 

This estimate includes 

In escrow? 

Estimated Taxes, Insurance 

Property Taxes 

YES 

& Assessments 

$305.08 

Homeowner's Insurance 

YES 

Amount can increase over time 

amonth 

other: 

See page 4 for details 

See Escrow Account on page 4 for details. You must pay for other property

Page 8

2 

Addendum to Closing Disclosure 

This Addendum includes additional information about the loan you have applied for. It does not replace any information disclosed on 

the Closing Disclosure. 

BORROWER 

— 

CO 

harper 

bee 

~> em 

( odd reSS 

D 

08 

SELLER 

only addres 

CALVIN H WELLINGTON 

16905 INVERNESS STREET 

DETROIT, MI 48221

Page 9

SETTLEMENT CERTIFICATION 

GUESS 

Loan 

MIN: 

Case 

NOTICE TO ALL PARTIES: If information is obtained which indicates that the source of the borrower's financial 

contribution is other than from the borrower or other than stated by the lender in its closing instructions, the 

settlement agent is to obtain written instructions from the lender before proceeding with settlement, 

CERTIFICATION OF BUYER IN AN FHA-INSURED LOAN TRANSACTION 

I certify that I have no knowledge of any loans that have been or will be made to me (us) or loans that have been 

or will be assumed by me (us) for purposes of financing this transaction, other than those described in the sales 

contract dated 

(including addenda). I certify that I (we) have not been paid or 

reimbursed for any of the cash downpayment. I certify that I (we) have not and will not receive any payment or 

reimbursement for any of my (our) closing costs which have not been previously disclosed in the sales contract 

(including addenda) and/or my application for mortgage insurance submitted to my (our) mortgage lender. 

~ BORROWER 

~- 

BRANDON 

ALEXANDER 

GUESS 

- DATE 

- 

¥ (OD 

-~ BORROWER - DEBORAH KING 

- DATE 

~ 

CERTIFICATION OF SELLER IN AN FHA-INSURED LOAN TRANSACTION 

I certify that I have no knowledge of any loans that have been or will be made to the borrower(s), or loans that 

have been or will be assumed by the borrower(s), for purposes of financing this transaction, other than those 

described in the sales contract dated 

(including addenda). I certify that I have 

not and will not pay or reimburse the borrower(s) for any part of the cash downpayment. I certify that I have not and 

will not pay or reimburse the borrower(s) for any part of the borrower's closing costs which have not been 

‘previously disclosed in the sales contract (including any addenda). 

- SELLER 

~ 

VICKIE WELINGTON 

~- DATE 

- 

~ SELLER 

- 

CALVIN 

H WELLINGTON 

~ DATE 

~ 

WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. 

Penalties upon conviction can include a fine and imprisonment. For details, see: Title 18 U.S. Code Sections 1001 

and 1010.

Page 10

[Space Above This Line For Recording Data] 

MORTGAGE 

DEFINITIONS 

Words used in multiple sections of this document are defined below and other words are defined in Sections 

3, 10, 12, 17, 19 and 21. Certain rules regarding the usage of words used in this document are also provided 

in Section 15. 

(A) "Security Instrument" means this document, which is dated OCTOBER 

4, 

2021, together with all 

Riders to this doimeat. 

US. Borrower is the EIOHARGE winder this Security Tstrumes, 

(C) "MERS" is Mortgage Electronic Registration Systems, Inc. MERS is a separate corporation that is 

acting solely as a nominee for Lender and Lender's successors and assigns. MERS is the mortgagee under 

this Security Instrument. MERS is organized and existing under the laws of Delaware, and has an address 

and telephone number of P.O. Box 2026, Flint, MI 48501-2026, tel. (888) 679-MERS. 

(D) "Lender" is PRIMELENDING, 

A PLAINSCAPITAL 

COMPANY. Lender is 

a CORPORATION 

organized and existing under the laws of TX. Lender's address is 18111 

PRESTON ROAD, 

SUITE 

900, 

DALLAS, 

TX 75252. 

(E) "Note" means the promissory note signed by Borrower and dated OCTOBER 

4, 

2021. The Note 

states that Borrower owes Lender ONE HUNDRED 

ONE THOUSAND 

ONE HUNDRED THIRTY-FOUR 

AND 

00/100 Dollars (U.S. $101,134.00) plus interest. Borrower has promised to pay this debt in 

regular Periodic Payments and to pay the debt in full not later than NOVEMBER 

1, 

2051. 

(F) "Property" means the property that is described below under the heading "Transfer of Rights in the 

FHA Michigan Mortgage - 09/15 

EX 

19380.20 

Page 1 of 

13 

1

Page 11

To whom it may concern, 

| am writing to formally request a review and correction of my Principal 

Residence Exemption (PRE) status. 

| missed the PRE filing deadline because 

| received my mail after the due 

date. Additionally, there was an error made by the title company, Abstract 

Title Company, at the time of closing. The co-signer of the property, my 

mother-in-law, Deborah King, was incorrectly listed as both a co-owner 

and as my wife. 

The property located at 16905 Inverness St is my primary residence. 

| 

have continuously occupied this home as my principal residence. Deborah 

King has never lived at this property. However, due to the way the 

ownership was recorded, the property is being reflected as Deborah King's 

secondary residence, which has resulted in the removal or denial of my 

Principal Residence Exemption. 

| respectfully request that this matter be reviewed, the ownership record 

be corrected, and my Principal Residence Exemption be reinstated. 

| am 

happy to provide any documentation necessary to support this request. 

Thank you for your time and consideration. 

| appreciate your assistance 

in resolving this matter as soon as possible. 

Sincerely,

Page 12

ERIC R. SABREE 

Make checks payable to: 

WAYNE COUNTY TREASURER 

Wayne County Treasurer 

400 Monroe - 5th Floor 

Detroit MI 48226-2942 

Taxpayer Information: 

< 

2 

(313) 224-5990 

PP 

ou 

pro 

i 

A 

oN 

ov 

[Ea 

Office Hours: 

8:00 a.m. 

- 4:30 p.m. 

Monday through Friday 

Web:treasurer.waynecounty.com 

Mailing 

Guess, Brandon & King, Deborah 

Email :taxinfo@waynecounty.com 

Address: 

16905 INVERNESS 

DETROIT MI 48221 

Tax Statement 

Number: 

2026 

- 36015 

Date: 

02/17/2026 

INARA SR 

UREA 

01-08009821. 

19315541 

Detroit Real Property Description: 

Property Classification: (401) Residential Real 

Parcel ID: 

08009821. 

SEV Amt: $58,400 

- 2025 

HSTD VAL: $33,417 

Address: 

16905 Inverness 

PRE: 100% 

NON HSTD VAL: $0 

Detroit, MI 48221 

Legal 

Description: W INVERNESS 223 LOG CABIN HEIGHTS SUB L31 P52 PLATS, W CR 8/171 50 X 119.02A 

Tax 

Total Amt 

— 

Year 

Base Tax 

Due 

Status Description 

2022 

$506.08 

$765.45 Homestead Denial on 

: 11/4/2025 

2023 

$531.38 

$724.01 Homestead Denial on 

: 11/4/2025 

2024 

$589.27 

$712.20 Homestead Denial on 

: 11/4/2025 

Total: 

$1,626.73 

$2,201.66 

If this property is available for payment, the amounts presented here are good on 

or before 02/28/2026. 

By providing these figures this office does not represent that this property can be 

redeemed or reclaimed. 

Created by:3869 

Page 

1 of 1

Page 13

ASSESSOR'S DATE STAMP 

2368 (Rev. 07-22) 

APP ROVED, 

Principal Residence Exemption (PRE) Affidavit 

| 

CITY 

OF DETROIT 

Issued under authority of Public Act 206 of 1893. 

Read the instructions before completing the form. This form must be filed with the assessor for the city or 

FEB 

1 7 2026 

township where the property is located. Do not submit this form if the property is not your principal residence 

and/or any of the disqualifying factors apply as listed in MCL 211.7(cc). For information regarding the PRE, 

please review the PRE Guidelines at www.michigan.gov/pre. 

: 

DRIVERS LICENSE/STATE ID Vv 

Michigan Department of Treasury 

Breer ERIFIED 

(OFFICE OF THE ASSESSCR 

Type or print in blue or black ink. 

PART 1: PROPERTY INFORMATION Type or print legibly. Use a separate form for each property tax identification number. 

1. Property Tax Identification Number 

2. Name of Local Unit (Check Township or City)| 

3. County 

oy 609s 2l. 

re 

Ubu 

. 

Stree! 

ress of 

Property 

(Provide 

a 

Complete 

“So 

De Foca \ 

JT 

Ee 

AD 

\ 

— 

Leap 

Nun ye ne 

6,0wner's 

ecurity Number | 7. Owner's Daytime Telephone Ga 

5. Name of Owner a Middle, Last 

Sanchar Mea ols Soo 

ER a9 

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

Security Number | 10. Co-Ownef's Enis) Number 

vin une 

3/2-720 StS =o 

1. Date you owned and occupied the property hie OHSU 

OE OOH OOORRORHREURRORORORY 

11. 

{ 

) 

OY 

i 

fonth 

Day 

Year 

The property in line 

1 above is my: 

11a. 

Principal residence 

11b. 

OUnoccupied adjoining or contiguous property that is classified residential or timber-cutover. 

12. 

List the percentage (100% to 1%) of the property that is occupied by the owner claiming the property as a principal 

residence. 

If the property has more than ane home on it, it is a multi-dwelling, used for purposes other than a 

principal residence, or partially rented, the owner may claim only a partial exemption. Please consult with your 

i 

0 

5 

local assessor to determine the percentage of the exemption the owner is allowed to claim in these situations........ 

12 

% 

13. Have you or your spouse claimed a principal residence exemption for another Michigan principal residence? 

....... 13. 

J Yes 

No 

14. 

If yes to 13, enter the property address and parcel number: 

NJ / A 

15. 

If yes to 13, have you rescinded that principal residence exemption? 

15. 

J Yes 

] No 

16. 

Do you or your spouse claim a similar exemption, credit or deduction on property located in another state?.......... 186. 

J] Yes 

To 

17. 

If yes 

to 16, enter the property address and parcel number: 

N IA 

18. Have you or your spouse filed a tax return as a non-resident of Michigan or resident of another state? 

................ 18. 

[I] Yes 

vi No 

19. 

If yes to 18, enter the state: 

NIA 

PART 2: CERTIFICATION 

Certification: | certify under penalty of perjury that 

| own and occupy as a principal residence on the date stated in Line 11 and that | have not claimed 

a substantially similar exemption/deduction/credit in property in another state, and that the information contained on this document is true and correct 

to the best of my knowledge. 

Date 

Ruder oats 

| 

2-026 

Iho lA 

re 

Da BPE

Page 14

PLACE STICKER AT TOP oF ENVELOPE 10 THE RIGHT 

ill hes 

OF THE RETURN ADDRESS, FOLD AT DOTTED LINE 

mm Cr Tr 

CERTIFIED MAIL® 

HOH 

9589 0710 5270 3114 92LL 

57

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