01._Property_Tax_Appeal_Petition_Form_Valuation_Poverty_Classification.4ec32f82-3b33-4c34-9722-190fff4d69a7.pdf

Adam S Jezewski Petitioner V City Of Dearborn Respondent · 26-000551-TT

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STATE OF MICHIGAN

GRETCHEN WHITMER

GOVERNOR

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

LANSING

ORLENE HAWKS

DIRECTOR

PROPERTY TAX APPEAL PETITION FORM

VALUATION / EXEMPTION / CLASSIFICATION APPEAL

MOAHR DOCKET NO. 

Do not use this form to appeal Principal Residence Exemption, Qualified Agricultural Exemption, Special Assessment, or Non-Property tax 

disputes.

Pursuant to Michigan Tax Tribunal Rule (TTR) 277(3), you MUST submit a copy of the notice giving rise to the appeal (e.g. Board of Review 

Decision or Notice of Uncapping) with this Small Claims Petition, if applicable. If you do not submit this document, you may be held in default.

Section 1: Petitioner’s Contact Information

Filer Type: Individual 

First Name

Adam

M.I.

S

Last Name/Company Name

Jezewski

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

22443 Cleveland Street

City or Town

DEARBORN

State

Michigan

ZIP Code

48124

Telephone Number

313-671-1804

Fax Number

E-mail Address

ajezajez@gmail.com

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

First Name

M.I.

Last Name

Firm Name (if any)

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

City or Town

State

Michigan

ZIP Code

Telephone Number

Fax Number

E-mail Address 

Section 3: Subject Property Information

How many parcels are you appealing?

1

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

 *If no, you must file separate appeals for each non-contiguous or non-adjoining parcel.

Property Address (No., Street, City, ST, ZIP) [If multiple, list first property’s address]

22443 Cleveland Street

STATE OF MICHIGAN

GRETCHEN WHITMER

GOVERNOR

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

LANSING

ORLENE HAWKS

DIRECTOR

DEARBORN

Michigan

48124

Taxing Authority (City or Township)

City Of Dearborn (WAYNE)

County 

Wayne

Section 4: Issues Being Appealed (check all that apply)

True Cash and Taxable Value, Uncapping of Taxable Value

 

Section 5: Explain the Reason for this Appeal

Good afternoon and thank you for your time. Having recently gone through a very difficult divorce, I purchased a small home for my 2 daughters and I near their 

high school here in Dearborn. One of my daughters stays with me 100% of the time, the other about 75% of the time. Their mom lives in Carlton MI, 35 minutes 

away. I paid above than the assessed value of the home due to its proximity to the children’s school, and because the previous owner disclosed no issues with the 

home. With this home I have discovered, and have been working to resolve, mold behind the bathroom walls, a variety of pluming issues, rusty and deteriorated 

steel air ducts due to dog urine that causes constant order within the home, living room and main floor flooring ruined by dog urine, basement concrete ruined by 

ferret urine, and more. As the single dad of 2 teenagers, with only my income to support us, along with having to make countless unexpected costly repairs, many of 

which likely known by the previous owners prior to sale, I am very worried about the increase in my yearly tax payments. Due to the chaos around the above 

mentioned home issue, balancing work and primary care for my daughters, plus travel to and from Nebraska due to my father’s recent short life expectancy 

prognosis as the result of pancreatic cancer, I was unable to appeal in person before the board in March. I do understand this is where I needed to begin this process, 

and I apologize for my absence. I am appealing today in the hopes of obtaining any assistance or relief possible for our current situation. Thank you again for your 

time, and for your consideration and understanding. – Adam Jezewski

Section 6: Jurisdictional Issues

Year(s) you are appealing:

2026

Did you protest the assessment at a Board of Review (BOR)? No

If Yes, check which BOR you attended AND upload the BOR decision: 

If No, check the applicable reason(s):

Appealing within 35 days of receipt of Notice of Uncapping

Did you request a Poverty Exemption at the BOR? 

If Yes, check which BOR considered your application AND upload the BOR decision: 

 March  July  December

If No, explain why:

Section 7: Valuation Information *Use the multiple parcel form for additional, contiguous parcels.

Parcel Identification Number: 82 09 282 13 027

Classification of Property:

Real

Residential

STATE OF MICHIGAN

GRETCHEN WHITMER

GOVERNOR

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

LANSING

ORLENE HAWKS

DIRECTOR

Current Assessed Value (also known as State Equalized Value) as established by the BOR:

86900

Current Taxable Value as established by the BOR:

86900

What do you believe is the fair market value (also known as True Cash Value)?

86900 

Multiply the True Cash Value by .5 and enter here. This is your contention of Assessed Value (also known as State Equalized Value).

43541

If you believe the Taxable Value differs from your contention of Assessed Value, enter your contention of Taxable Value.

43541

Section 8: Classification Information *Only the MI Dep’t of Treasury may appeal this issue to the Tribunal*

Parcel Identification Number:

 

Current Classification of Property as established by Board of Review:

What do you believe is the property’s classification?

If improved property, how is the property currently being used?

If improved property, for what use was the property designed?

Fee Information

Does the subject property have a Principal Residence Exemption of at least 50% as of the date of the filing of this petition?

Yes

Are you appealing ONLY the denial of a Poverty Exemption?

No

If you answered yes to either or both of these questions, you are not required to pay any filing fees.

The filing fee is based on the greater of the State Equalized Value or Taxable Value in contention. If you are appealing more than one parcel, the parcel with the 

highest State Equalized Value or Taxable Value in contention will be used to determine your filing fee, plus $25.00 will be added for each additional parcel being 

appealed, not to exceed a total filing fee of $1,000.

If your property is residential property (see MCL 205.762) and

the State Equalized Value or Taxable Value in contention is: Filing Fee is:

$100,000.00 and under $125.00

$100,000.01 to $500,000.00 $200.00

$Over $500,000.00 $300.00

If your property is NOT residential property (see MCL 205.762) and

the State Equalized Value or Taxable Value in contention is: Filing Fee is:

$100,000.00 and under $250.00

* Plus $25.00 for each additional parcel, as indicated above.

If your property is NOT residential property and the State Equalized Value or Taxable Value in contention is $100,000.01 or greater the appeal does not qualify for 

Small Claims. Therefore, an Entire Tribunal petition must be filed.

STATE OF MICHIGAN

GRETCHEN WHITMER

GOVERNOR

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

LANSING

ORLENE HAWKS

DIRECTOR

Electronic Signature *Typing your name below will serve as your signature

Petitioner or Attorney/Authorized Representative’s Signature: 

/s/ Adam Jezewski

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