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 Michigan. DepartmentL ¢ "y of Treasury{ ! rN DATE STAMP 2368 (Rev, 07.0%) © ASSESSOR'S

 Principal Residence Exemption (PRE) Affidavit

 Issued unde: authority of Public Act 208 of 1883
 Read the instructions page before completing the form. This form must be filed the assessor for the city of |
 township where the property is located. DO NOT SUBMIT THIS FORM IF THE PROPERTY IS NOT YOUR : | b-
 PRINCIPAL RESIDENCE AND/OR ANY OF THE DISQUALIFYING FACTORS APPLY AS LISTED INMCL 211.7 9
 (CC). For information regarding the PRE, please review the PRE Guidelines at www.michigan.gov/pre. >

 —— 23 Type or Print in blue or black ink. 2-14
 ——— —— —_— ——— — ——
 Part 1: Property Information Type or print legibly. Use a separate form for each property tax identification number

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 1. Property tax identification number 3. County 2. Name of Local Unit (Check Township or City)
 KALAMAZOO 3906-18-265-060 [x] Township [7] City ~~ KALAMAZOO TOWNSHIP |
 4. Street Address of Property (Provide a Complete Address)

 3408 OLNEY ST

 |! ——— es———— ——— _——
 6. Owner's Last Four Digits of Social Security Number [ 7. Owner's Daytime Telephone Number 5. Name of Owner (First, Middle, Last) ———
 MALONEY, DAVID J. & JOYCE A. IG — 744-2249
 |-— | XXX-XX- 15D
 I 10. Co-Owner's Daytime Telephone Number 8. Name of Co-Owner's (First, Middle, Last) 9. Co-Owner's Last Four Digits of Social Security Number

 a
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 1. rid td 5. 1/977 11. Date you owned and occupied the property in line 1 TR RR Lo i Sh

 Year Month Day
 The property in line 1above is my: 11a. Principal residence
 11b. Unoccupied adjoining or contiguous property that is classified residential or timber-cutover. i

 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 one 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 local
 assessor to determine the pecentage of the exemption the owner is allowed to claim in these situations... br 5 ~ %

 13. Have you claimed a principal residence exemption for another Michigan principal residence? ...................oe. 13. [A Yes [] No

 14. If yes to 13 enter the address and parcel number _ eld a - rm rT! erry

 15. If yes to 13, have you rescinded that principal residence exempltion?.............ocoiiiiiinn. i Zk BRACE A 8 LI 15. [2] Yes 22 No

 16. Do you or your spouse claim a similar exemption, credit or deduction on property located in another state?......... 16. [| Yes [1] No

 17. If yes to 16 enter the address and parcel number A ShEE dee lic 30 2 }
 18. Have you or your spouse filed a tax return as a non-residence of Michigan or a resident of another state....... 18. [] Yes [] No

 cL RC Shit 19. If yes to 18, enter state

 -— - - — = —
"PART— 2:— CERTIFICATION
 Certification: | certify under penalty of perjury that! own and occupy as a principal residence on the date statedin Line 11 and that | have not claimed a substantially similar

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 4-2 fale
 wner's Signatyr

 PR GRR eRe Py Seep SRD aa STR ESR NE TH a 2, NE a SU Ae IE TEL LY FS Lbod hb ha bo dokd, Ri bE LLL Bh 23. dof 23. Indicate Property Classification

 . a — pt
} What is the year the Affidavit will be posted to the tax roll? Did the Assessor Approve,or Depy the Affidavit?
 Angidved o%| 0% 2039 B Denied (Attach a copy of the Local Unit Denial)
 ie Certification: | certify that, to the best of my kno e, the informal] n this form is complete and accurate
 [Date Certified by Assessor (MWDD/YYYY)
 Assessor's Signature
 08(4/ 2023