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Lois E Blumka, Petitioner V Township Of Bear Creek, Respondent · 26-000357-TT

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Page 1

RECEIVED 

Bear Creek Township 

APR 09 2025 

373 Division Road 

pp 

Petoskey, Michigan 49770 

“la TRIBUNAL 

Phone: 231-347-1311 Fax: 347-0736 

Email: supervisor@bearcrecktownshipmi.gov 

March 26, 2026 

Michigan Tax Tribunal 

611 W. Ottawa Street 

P.O. Box 3032 

Lansing, Mi. 48909 

RE: MTT DOCKET 26-000357 

To Whom it May Concern, 

Please find enclosed the PRE Answer Form, and explanation with 

exhibits for MTT Docket 26-000357: 

On October 26, 2020, Lois Blumka applied and was granted a PRE 

for her property located at 1103 Park Ave, Petoskey, Mi. 49770 

(exhibit 1) 

On April 24, 2024 

| received an e-mail from the Michigan Department 

of Treasury denying the PRE for tax years 2021, 2022, 2023 & 2024 

(exhibit 2) 

On November 5, 2025, Lois Blumka came into my office and 

completed a 2025 PRE form (exhibit 3) and 

| explained to her that 

| 

would require her to give me a copy of her 2024 State & Federal 

income tax forms per the Michigan Department of Treasury Principle 

Residence Exemption Guidelines page 27 (exhibit 4) because 

treasury had previously denied her PRE. Lois told me she didn't file

Page 2

On January 13, 2026, Lois Blumka again came into my office and 

said she didn’t receive the December 3, 2025 letter until after the 35 

day appeal period and asked if she could apply for 2026 which she 

did (exhibit 6) and she then gave me a copy of an unsigned 2024 

Michigan Income Tax Return and a copy of an unsigned New York 

State Resident Income Tax Return (exhibit 7) but no Federal Tax 

return as 

| had required previously. 

| did call the Department of 

Treasury for verification if Lois Blumka had filed a 2024 Michigan Tax 

Return and they couldn’t give me that information. 

On Feb. 2, 2026, 

| sent the Notice of Denial of Principle Residence 

Exemption for 2026 (exhibit 8) 

| would request the tribunal to request the filed Michigan Income Tax 

Returns, request a copy of the filed Federal Tax Returns because the 

subject property is owned jointly by Anthony E Blumka & Lois E 

Blumka Husband & Wife (exhibit 9) but only Lois is claiming the PRE 

to verify that separate state and federal tax returns were filed. 

Sincerely, oy 

Dennis Keiser 

Supervisor/Assessor 

R-8093

Page 3

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON 1. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

PROPERTY TAX APPEAL ANSWER FORM 

PRINCIPAL RESIDENCE EXEMPTION / QUALIFIED AGRICULTURAL EXEMPTION 

MTT DOCKET NO, 26-000857 

Section 1: Respondent’s Contact Information 

Unit of Government 

BEAR CREEK TOWNSHIP 

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

First Name 

ML 

Last Name 

DENNIS 

M 

KEISER 

Firm Name (if any) 

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

373 N DIVISION ROAD 

City or Town 

State 

ZIP Code 

PETOSKEY 

MI 

[49770 

Telephone mera 34 -347-1 3 1 

1 

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

supervisor@bearcreektownshipmi.gov 

Section 3: Subj ect Property Information suse the multiple parcel form for additional, contiguous parcels. 

Are the parcels listed by Petitioner contiguous or adjoining? 

If no, list all parcels that are adjoining in separate groupings. Attach a 

Separate sheet if necessary. 

O Yes 

[] No 

Not 

Applicable 

Parcel Identification Number: 

24-01-16-33-201-003 

Classification of Property: 

Real 

Personal [J {check one) 

Agricultural [1 

Commercial 

3 

Industrial 00 

Residential 

Timber-Cutover [1 

Developmental J 

Utility [] (check one) 

Does the property have a Principal Residence Exemption of 50% or more for all tax years at issue? 

[mn] Yes 

No

Page 4

STATE OF MICHIGAN 

GRETCHEN WHITMER 

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS 

MARLON I. BROWN, DPA 

GOVERNOR 

LANSING 

DIRECTOR 

Section 4: Explain Your Answer to this Appeal 

See Attached letter and attachments 

Section 5: Jurisdictional Issues 

Check what action prompted this appeal: 

Notice of Denial of Principal Residence Exemption 

O Denial by Board of Review 

Od Denial by Dept. of Treasury 

O Other 

If you checked “other” above explain: 

If Petitioner is appealing from a Board of Review denial, check which Board of Review took action: 

Od March 

Od July 

a December 

List the date the Principal Residence Exemption or Qualified Agricultural Exemption was denied: 

Feb. 2, 2026 

Tax year(s) “2026 

Signature *Required 

Respondent or Attorney/A 

rized Representative’s Signature: 

SU 

ecsng 

Cedls

Page 5

oa Daag Of Treasury 

ASSESSOR'S 

DATE STAMP 

Principal Residence Exemption (PRE) Affidavit 

) ECE 1v E 

Issued under authority of Public Act 206 of 1893. 

1 

Read the instructions page before completing the form. This form is not valid unless certified by the assessor. 

0CT 

5 

Do not submit this form if the property is not your principal residence and/or any of the disqualifying factors 

en 

2020 

apply as listed in MCL 211.7(cc). For information regarding the PRE, please review the PRE Guidelines at 

www.michigan.gov/pre 

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 

24-01-16-33-201-003 

[%] Township [7] Cty 

~ BEAR CREEK TOWNSHIP 

Emmet 

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

1103 PARK AV 

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

6. Owner's Last 

wR 

ial Security Number 

7. Owner's Daytime Telephone Number 

Y 

ee 

- 

BLUMKA ANTHONY E. & LOIS E. 

XXX-XX- 

QUT Hep 2202 

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

9. Co-Owner's LI 

Social Security Number | 10. Co-Owner's Daytime Telephone Number 

XXX-XX- 

11. Date you owned and occupied the property inline 1... 

11. 

FO 

20 

Month 

Day 

Year 

The property in line 1above is my: 

11a. 

A 

Principal residence 

11b. 

[] 

Unoccupied 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 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...... 

12. Ke % 

13. Have you claimed a principal residence exemption for another Michigan principal residence?.............cccccoeuninnce 

13. 

] Yes 

14. 

If yes to 13 enter the address and parcel number 

15. 

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

No 

16. 

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

No 

17. 

If yes to 16 enter the address and parcel number 

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

18. 

ral Yes 

No 

19. 

If yes to 18, enter state 

N ya 

Yo VQ 

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. 

20. Owner's Signature 

- 

Date 

Ger 

oo 

Spent 

/6/ zy 20 

21. Co-Owner's Sighature 

/ 

Date 

’ 

22. Mailing Address, if Different than Property Address above

Page 6

Denny Keiser 

E—_— 

= 

= 

—= 

—— 

—_—— = 

——_———=— 

From: 

Treas-PRE <Treas-PRE@michigan.gov> 

Sent: 

Thursday, April 25, 2024 2:59 PM 

To: 

mmitchell@emmetcounty.org; Supervisor; upnorthassessor@gmail.com; 

couturenick@hotmail.com; harbortim@gmail.com; harbortim@gmail.com; 

jvandivner.friendship@gmail.com; assessor@cityofharborsprings.com; 

upnorthassessor@gmail.com; assessor@littlefieldtwp.org; assessor@tbconsulting.us; 

socha.linda@gmail.com; assessor@assessingoffice.com; assessorjeff@gmail.com; 

BNAssessing@gmail.com; supervisor@resorttownship.org; 

assessor@springvaletownship.org; rmoore@wawatamtownship.org; 

assessor@westtraversetownship.com 

Subject: 

PRE Denial List 

Attachments: 

Emmet.xlsx; 2024 Bona fide Purchaser Exception.pdf; 2024 PRE Denial FAQ.pdf 

Instructions to Process Michigan Department of Treasury Priripal chibi 

Residence Exemption Denial Lists 

Attached is a list of the Principal Residence Exemption (PRE) denials issued by the Michigan 

Department of Treasury in your county. Also attached is Frequently Asked Questions which is 

provided to the taxpayer with the denial notice and a bona fide purchaser exception sheet to further 

explain situations involving a bona fide purchaser. 

Upon receipt of this list of PRE denials, please complete the following instructions: 

1. Assessors shall remove the PRE from the tax roll for the tax years denied and subsequent years 

EXCEPT in the following instances: (Valid Exceptions) 

o 

The property received or should have received a Qualified Agriculture Exemption or Qualified 

Forest Exemption for the tax years denied. The Michigan Department of Treasury is not 

denying an Agricultural Exemption or Qualified Forest Exemption and 

it is not reviewing the 

validity for these exemptions. Assessor's may have erroneously placed a PRE on these types 

of properties since these exemptions have similar tax savings as a PRE. Assessors shall fix 

the error to correctly reflect the exemption the owner should be receiving. 

e 

The parcel number listed on the denial is incorrect. 

o 

The person(s) denied did not own the property for some or for all the tax years denied. 

o 

An eligible taxpayer filed a new valid PRE Affidavit (Form 2368) with the assessor for a

Page 7

principal residence and claimed the PRE (Filed Form 2368) for the tax years denied, leave the 

PRE on the tax roll since she had a valid claim for the tax years denied and her claim was not 

denied by the Michigan Department of Treasury. 

e 

The property was sold to a bona fide purchaser. (See enclosed “bona fide purchaser 

' 

exception” sheet for further information regarding these situations.) 

NOTE: An Assessor's belief that a person(s) denied the PRE by the Michigan 

Department of Treasury qualified for the PRE for any of the tax years denied is not an 

exception. An assessor erroneously classified a contiguous or adjacent parcel as 

anything other than residential or timber cut-over is not an exception. 

. Assessors shall notify the Michigan Department of Treasury and County Treasurer if any valid 

exception existed and provide details of any valid exception as described above for any of the 

parcels on the PRE denial list. 

. Assessors shall provide a copy of the denial list to their Local Unit Treasurer along with the 

assessor's noted valid exceptions. 

. 

County Treasurers shall provide a copy of the denial list to their Equalization Director along with 

the assessor's noted valid exceptions. 

. County Treasurers and Local Treasurers shall amend the tax roll in their possession to 

reflect the denial and shall within 30 days of the date of the denial issue a corrected tax bill 

for any additional taxes with interest at the rate of 1.25% per month or fraction of a month 

and penalties computed from the date the taxes were last payable without interest and 

penalty unless there was a valid exception noted by the assessor. 

NOTE: You are required to bill if the noted assessor exception is not one of the valid exceptions 

listed above. 

. County Treasurers and Local Treasurers shall not waive interest. There is no statutory authority 

for the county or local unit to waive interest resulting from these denials. 

. County Treasurers and Local Treasurers shall submit a Request to Bill Seller Following a PRE 

Denial (Form 4816), for any bona fide purchaser exceptions determined above (see enclosed 

“bona fide purchaser exception” sheet).

Page 8

10. Assessors, County Treasurers and County Equalization Directors shall not issue denials on 

the same parcels, for the same owners, and same years denied by the Michigan Department of 

Treasury. 

If you have any questions regarding your responsibilities, please contact the Principal Residence 

Exemption Unit at (517) 335-7487 or PRE@michigan.gov. 

If taxpayers have any questions, please refer them to the attached Frequently Asked Questions. 

They may also call the PRE Audit Call Center at (888) 909-2799. 

Thank you. 

Principal Residence Exemption Unit 

Michigan Department of Treasury

Page 9

011633201003 

521632401018 

411710302011 

111321400003 

EMMET 

EMMET 

EMMET 

EMMET 

EMMET Total 

BEAR CREEK TWP 

1103 

PARK AV 

CITY OF PETOSKEY 

122 

ROSEDALE AVE 

LITTLEFIELD TWP 

7620 

BASS AVE 

PLEASANTVIEW TWP 

3900 

S PLEASANTVIEW RD 

H

Page 10

| ANTHONY E BLUMKA & LOIS E BLUMKA 

11

ROBERT J TIMYAN TRUST 

C/O MARK TIMYAN 

51

FREDRICK E HOLLERBACK & ROBERT L HOLLERBACK 

STEPHEN MICHAEL KOSKUC & MICHAEL WAYNE KOSKUC 

63

Page 11

49770 

April 

26, 2024 

48439-2049 April 

26, 2024 

49706 

April 

26, 2024 

49740 

April 

26, 2024 

NONRESIDENT 

NOT OWNER OCCUPIED 

RENTAL PROPERTY 

NOT OWNER OCCUPIED 

2024 

2024 

2024 

2024 

2023 

2023 

2023 

2023

Page 12

Michigan Department of Treasury 

2368 (Rev. 07-22) 

Principal Residence Exemption (PRE) Affidavit 

Issued under authority of Public Act 206 of 1893. 

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

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. 

ASSESSOR'S DATE STAMP 

) es NP Ios UV 

Lose 

| 

NOV 

5 2025 

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 

01-16-33-201-003 

[x] Township [7] Cty 

~~ BEAR CREEK TOWNSHIP 

Emmet 

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

1103 PARK AV 

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

6. Owner's L: 

Digits of Social Security Number 

7. Owner's Daytime Telephone Number 

BLUMKA LOIS E. 

XXX-X 

717 498 222 

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

9. Co-Owner] 

ocial Security Number | 10. Co-Owner’s Daytime Telephone Number 

XXX-XX- 

11. Date you owned and occupied the property in line 1 ..... Ze] l= 

1". 

7 

2) 

Zol% 

P— 

. 

Mi 

The property in line 1above is my: 

11a. 

[A Principal residence 

on 

Dey 

11b. 

O 

Unoccupied adjoining or contiguous property that is classified residential or timber-cu! 

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...... 

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

14. 

If yes to 13 enter the address and parcel number 

15. 

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

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

17. 

If yes to 16 enter the address and parcel number 

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

19. 

If yes to 18, enter state 

PART 2: CERTIFICATION 

Certification: I 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 hest of my knowledge. 

20. Owner's Signature 

i 

Date 

; 

ad 

Sfoswlen 

a Jf S = 

7 

Date 

21. Co-Owner's Signature 

22. Mailing Address, if Different than Property Address above

Page 13

"A “Substantially Similar Exemption” means the Michigan principal residence exemption and the 

other state’s exemption statute requirements to receive the exemption are substantially 

similar. (i.e., it must be owned and occupied as a principal residence to receive the exemption). 

It does not mean a person receives a substantially similar tax savings. Levenfeld v County of 

Berrien, unpublished opinion per curiam of the Court of Appeals, issued January 12, 2012 

(Docket No. 300358). 

76. 

What does “claim for a similar exemption” mean? 

A claim for a similar exemption occurs at the time of the “filing or granting of that exemption” 

in the other state. 

77. 

ls there a penalty for claiming a similar exemption in another state and in Michigan? 

Yes. MCL 211.7cc(3) prescribes a $500 penalty for a person who claimed a Michigan principal 

residence exemption and a substantially similar exemption in another state. In addition, to the 

$500 penalty, the owner's principal residence exemption should be denied for tax years the 

owner received a similar exemption in another state (up to the current and previous three 

years) resulting in a substantial amount of taxes and interest owed. The penalty shall be eh 

distributed in the same manner as interest is distributed under MCL 211.7cc(25). 

A married couple “may” receive a principal residence exemption in Michigan and a 

substantially similar exemption in another state if all the following apply: 

1. 

The spouse claiming the principal residence exemption in Michigan is the owner of the 

Michigan property; 

2. 

The spouse claiming the principal residence in Michigan occupied the Michigan property 

as his or her principal residence and not as a seasonal home; 

3. 

The spouse claiming the principal residence exemption in Michigan did not also claim a 

substantially similar exemption in the other state;

Page 14

Michigan Department of Treasury 

2742 (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 h 

been denied. If you have questions about the denial, you may contact your local government or follow the 

appeal procedures specified below. For more information regarding the Principal Residence Exemption (P 

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

1. 

Property tax identification number 

2. Name of Local Unit (Check Township or City) | 3. County 

Tovnshi 

) 

01-16-33-201-003 

Hoy" Bear Creel 

Emmet 

4. 

Streetaddress of property (Provide a Complete Address) 

1103 PARK AV 

5. 

Name of Owner (First, Middle, Last) 

6. Owner's Last Four Digits of Social Security Number 

7. 

Owner's Daytime Telephone Number 

BLUMKA LOIS E. 

wooo JR 

NT-498- 2203 

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- 

11. 

Mailing address if different than property address (street or RR#, city, state, Zip code) 

y 

2 

_E. 72% 

St (aw York 

| Mew 

joor( 

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

[J 

a. The owner is not a Michigan resident. 

[os] 

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

| 

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

O 

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

[J 

e. Other; 

13. Claim Denied for Calendar Year(s): 

14. 

Percentage Adjusted to: 

(see instructions) DOS 

Ss il 

% 

[PART 2: CERTIFICATION 

15. 

Name 

of the Local Assessor (Print or Type) 

GINS 7 eSet— 

16. SignAtyre of Local Asses 

17. 

Date 

te ye 

Re 25 

. 

Address and 

Telephone Number of Local 

Government 

“SW. Dwsan BD 

fosle, pe wtzoe 

7 

19. 

Email Address of Assessor 

Svperv(s o7/<) baarereeldowmsh iphtle gov 

= 

i 

Shaka 

Homeowner's Right to Appeal

Page 15

Michigan Department of Treasury 

2368 (Rev. 07-22) 

Principal Residence Exemption (PRE) Affidavit 

Issued under authority of Public Act 206 of 1893. 

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

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. 

Type or Print in blue or black ink. 

Part 1: Property Information 

Type 

c 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 

01-16-33-201-003 

[] Township [7] Gly 

BEAR CREEK TOWNSHIP 

Emmet 

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

1103 PARK AV 

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

6. Owner's Last, 

we 

ial Security Number 

7. Owner's Daytime Telephone ae 

BLUMKA LOIS E. 

XXX-XX- 

271-498-3303 

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

9. Co-Owner’s L 

cial Security Number | 10. Co-Owner's Daytime Telephone Number 

XXX-XX- 

w._) 

22 

205 

The property in line 1above is my: 

11a. 

BA Principal residence 

Month 

Day 

Year 

11b. 

 [] 

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

11. Date you owned and occupied the property in line 1 

. 

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 

or 

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

12. 

yale) 

(d 

% 

’ 

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

13. 

] Yes 

X No 

14. 

If yes to 13 enter the address and parcel number 

15. 

If yes to 13, have you rescinded that principal residence exemption?............cocouiniiiniiiininie 15. 

J Yes 

16. 

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

16. 

] Yes 

17. 

If yes to 16 enter the address and parcel number 

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

; 

18, 

Bre 

ED 

19. 

If yes 

to 18, enter state 

Hy 

Nu spend an les in HY 

[fle 

[1 

Zk 

| 

» 

PART 

2: CERTIFICATION 

Certification: I 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/creditin property in another state, and that the information contained on this document is true and correct to the best of my knowledge. 

20. Owner's Signafure 

Date / 

Ae 

Sordi 

1% /. 2¢ 

¥ 

21. Co-Ofiner's Signature 

/ 

22. Mailing Address, if Different than Property Address above

Page 16

Michigan Department of Treasury (Rev. 04-24), Page 

1 0f 3 

Issued under authority of Public Act 281 of 1967, as amended. 

2024 MICHIGAN Individual Income Tax Return MI-1040 

Amended Return [] 

Return is due April 15, 2025. 

(Include Schedule AMD) 

1. Filer's First Name 

M.I. 

| Last Name 

2. Filer's Full Social Security No. (Example: 123-45-6789) 

LOIS 

E | BLUMKA 

If a Joint Return, Spouse's First Name 

M.I. 

| Last Name 

45-6789) 

Home Address (Number, Street, or P.O. Box) 

1103 PARK AVE 

City or Town 

State 

| ZIP Code 

4. School 

PETOSKEY 

MI 

| 49770 

24070 

5. 

STATE CAMPAIGN FUND 

6. 

FARMERS, FISHERMEN, OR SEAFARERS 

Check if you (and/or your spouse, if 

a. 

Filer 

= 

filing a joint return) want $3 of your taxes 

Check this box if 2/3 of 

: 

f 

: 

J 

idan 

a 

your income is from farming, 

to go to this fund. This will not increase 

opt 

+ 

your tax or reduce your refund. 

b. 1 Spouse 

fishing, or seafaring. 

7. 

2024 FILING STATUS. Check one. 

8. 

2024 RESIDENCY STATUS. Check all that apply. 

a. J 

Single 

* If you check box "c," complete 

a. 

Resident 

line 3 and enter spouse's full name 

* If you check box "b" or 

b. 1] 

Married filing jointly 

below: 

b. ™ 

Nonresident* 

"You must sample 

NR. 

c. 

Married filing separately* 

ANTHONY BLUMKA 

[3 J 

Part-Year Resident* 

9. 

EXEMPTIONS. NOTE: 

If someone else can claim you as a dependent, check box 9e, enter 0 on line 9a and enter $1,500 on line Je (see instr.). 

a. 

Number of exemptions (see instructions) 

ga | 

1 

x 

$5600 

Ya. 

5600 

Joo 

b. 

Number of individuals who qualify for one of the following special exemptiol 

blind, hemiplegic, paraplegic, quadriplegic, or totally and permanently disabled... 

9b. 

x 

$3,300 

9b. 

00 

¢. 

Number of qualified disabled veterans... 

9c. 

x 

$500 

9c. 

00 

d. 

Number of Certificates of Stillbirth from MDHHS (see instructions) 

9d. 

x 

$5,600 

9d. 

00 

e. 

Claimed as dependent, see line 

9 NOTE@bove 

iii, 

9e. 

Qe. 

1. 

Add lines 9a, 9b, 9c, 9d and Qe. Enter here and on line 15 

___.._.......ooioiiooiioeece ieee 

of. 

5600 

Joo 

10. 

Adjusted Gross Income from your U.S. Form 7040 (568 instructions) o.com 

10. 

527 

Joo 

11. 

Additions from Schedule 1, line 9. Include Schedule 1 

1. 

00 

12. 

Total AQANNBS 10AN 11 

| 

oor ornocnsosssnssmssssssassmsonsessenssdsssss 

ia ios sss Ss SRR HBAs 

iss TUS 

12. 

527 

oo 

13. 

Subtractions from Schedule 1, line 31. Include Schedule 1 

13. 

00 

14. 

Income subject to tax. Subtract line 13 from line 12. If line 13 is greater than line 12, enter "0"... 

14. 

527 

[oo

Page 17

2024 MI-1040, Page 3 of 3 

REFUND OR TAX DUE 

34. 

Filer's Full Social Security Number 

If fine 33 is less than ling 24, subtract line 33 from ling 

24, If applicable, see instructions. 

Include interest 

00} 

and penalty 

00) 

YOU OWE 

34. 

Qo 

35. 

Overpayment, 

if line 33 is greater than line 24, subtract line 24 from line 33... 

35. 

00 

36. 

Credit Forward. Amount of line 35 fo be credited to your 2025 estimated tax for your 2025 tax return... 

36. 

00 

REFUND 

37. 

00 

37. 

Subtract line 36 from line 35 

DIRECT DEPOSIT 

Deposit your refund directly to your 

financial institution! See instructions 

and complete a, b and c. 

a. Routing Transit Number 

b. Account Number 

¢. Type of Account 

1 [1 Checking 

2. [savings 

Deceased Taxpayer. 

If Filer and/or Spouse died after December 31, 2023, enter dates below. 

ENTER DATE OF DEATH ONLY. 

Example: 04-15-2024 {MM-DD-YYYY} 

Preparer Certification. 

t declare under penalty of perjury that this return is 

based on alk information of which | have any knowledge. 

Filer 

Spouse: 

Taxpayer Certification. 

J declare under penalty of perjury that the information in this 

return and attachments is true and complete to the best of my knowledge. 

Preparer’s PTIN, FEIN or SSN 

MARK LENSKI, 

CPA 

EK] By checking this box, | authorize Treasury to discuss my return with my preparer. 

Fiter's Signature 

Date 

Preparer's Signature 

MARK LENSKI, 

CPA 

Spouse's Signature 

Date 

Preparer's Business Name, Address and Telephone Number 

APRIO ADVISORY GROUP, 

LLC 

350 STH AVENUE, 

SUITE 4320 

NEW YORK, 

NY 10118 

212-697-8540 

Refund, credit, or zero returns, Mail your return to: 

Pay amount on line 34 (see instructions). Mail your check and return to: 

Michigan Department of Treasury, Lansing, Mi 48956 

Michigan Department of Treasury, Lansing, Mi 48929

Page 18

Department of Taxation and Finance 

458001 12-03-24 

NEW 

N 

. 

YORK 

Resident Income Tax Return 

IT-201 

STATE 

New York State ® New York City ® Yonkers ®¢ MCTMT 

2024 

3 

For the full year January 1, 2024, through December 31, 2024, or fiscal year beginning 

and ending _ 

For help completing your return, see the instructions, Form IT-201-1, 

Your fast name 

Mi | Your last name (for a joint return, enter spouse's name on fine balow) 

Your date of birth (mmddyyyy) 

Your Sociat Security number 

ANTHONY 

BLUMKA 

Spouse's firstname 

Mt | Spouse's last name 

Now York State county of residence 

Mailing address {see instructions) {number and street or PO Box) 

Apartment number 

125 SUMMIT ROAD 

ORAN 

le} 

City, villags, or post office 

State | ZIP code 

Country 

School district name 

xX 

TUXEDO 

PARK, 

NY 

10987 

NY 

[10987 

TUXEDO 

> 

Taxpayer's permanent home address (see instructions) (number and street or rural route) 

Apartment number 

2 

Sma 

[eis] 2 

Clty, village, or post office 

State | ZIP code 

Taxpayer's date of death {mmddyyyy} 

Spouse's date of death (mmddyyyy} 

3 

NY 

Decedent 

2 

information 

] 

[ 

| 

J 

i. 

D1 

Did you have a financial account located 

~ 

A 

Filing 

oO [I 

Single 

in a foreign country? 

Yes 

No 

o 

ied 

filing 

iof 

D2 

(1) 

Did you or your spouse maintain living 

(mark an 

Married filing joint retum 

Hy 

X inone 

® [I 

(enter spouse's Social Security number above) 

quarters in Yonkers for any part of 20247 Yes 1 

No 

ul 

box): 

® 

Married filing separate retum 

If ves: 

| 

. 

. 

— 

~ 

(enter spouse's Social Security number above) 

(2) 

Number of months you lived in Yonkers in 2024 

Pe) 

m 

®@ | 

Head of household (with qualifying person} 

(3) 

Number of months your spouse lived in Yonkers in 2024 — 

w 

if No: 

o 

® 1 

Qualifying surviving spouse 

(4) 

Did you or your spouse work in Yonkers while 

~ 

B 

Did you itemize your deductions on 

not living in Yonkers for any part of 2024 

Yes 

No 

XI 

your 2024 federal income tax return? Yes 

No Cd 

. 

Lo 

. 

m 

E 

(1) 

Did you or your spouse maintain living quarters in 

po] 

C 

can you be claimed as a dependent 

NYC (this includes the Bronx, Brooklyn, Manhattan, 

on another taxpayer's federal retum? 

| 

Yes J 

Queens, and Staten Island) during 2024? 

Yes 

No 

3 

(] 

] 

5 

i 

(2) 

Enter the number of days spent in NYC in 2024 

A 

> 

* 

v 

\ 

iret 

4 iE 

(any part of a day spent in NYC is considered a day) --- 

2 

h 

d 

F 

NYC residents and NYC part-year residents only: 

[7,) 

{1) 

Number of months you lived in NYCin2024 

1 

® 

0 

fet 

8 

0A 

en 

2 

{2) 

Number of months your spouse lived in NYC in 2024 1 

> 

. 

. 

G 

Enter your 2-character special condition 

=~ 

H Dependent information 

code{s) if applicable 

RE 

1 

< 

First name 

Mi 

Last hame 

Relationship 

Social Security number 

Date of birth mmddyyyy) 

Fd 

SS 

3 

~ 

[77] 

Mm 

oO 

g

Page 19

488004 12-03-24 

If the funds for your payment (or refund) would come from {or go to) an account outside the U.S., mark an 

x in this box 

] 

Personal savings 

83a 

Account type: 

Personai checking 

- or - 

sab Routngrumper [7] 

83c_ 

Account number 

[ 

Page 4of4 

 IT-201 (2024) 

62 Enter amount from line 61 

62 

00 

[Payments and refundable credits 

| 

63 

Empire State child credit 

.00 

1 

64 

NYS/NYC child and dependent care credit 

64 

00 

65 

NYS eamed income credit (EIC) 

65 

00 

/ 

66 

NYS noncustodial parent EIC 

66 

00 

{ 

4 

67 

Real property tax credit 

67 

00 

68 

College tuition credit 

68 

00 

4 

69 

NYC school tax credit (fixed amount) (also complete F on page 1} 

69 

.00 

yu 

69a 

NYC school tax credit {rate reduction amount) 

69a 

.00 

70 

NYC earned income credit 

79 

.00 

70a 

This line intentionally left blank 

70a 

71 

Other refundable credits (Form IT-201-ATT, line 18) 

71 

oo} 

lf applicable, complete Foris) I7-2 

72 

Total New York State tax withheld 

_ 

72 

RY 

Your roti 

ne 

submit 

fem 

73 

Total New York City tax withheld 

73 

.00 

74 

Total Yonkers tax withheld 

74 

00] Donot 

send federal Farm W-2 

75 

Total estimated tax payments and amount paid with Form IT-370|_75 

.00 

76 

Total payments (add lines 63 through 75) ............ 

OPTION 

N 

[ 

76] 

.00 ] 

I Your refund, amount you owe, and account information 

] 

77 

Amount overpaid (if line 76 is more than 

line 62, subtract line 62 from line 76) 

77 

00 

78 

Amount of line 77 available for refund (subtract fine 79 from fine 77) 

.. 

78 

-00 

TIP: Use this amount to check your refund status online. 

78a 

Amount of line 78 that you want to deposit into a NYS 529 account (Form 17-195, line 4) (also submit Form IT-195){78a 

.00 

78b 

Total refund after NYS 529 account deposit (subtract line 78a from line 78) 

78b 

00 

direct deposit to checking or 

In paper 

Mark one refund choice: 

savings account (fill in line 83) 

check 

Refund? Direct deposit is the 

3 

) 

easiest, fastest way to get your 

79 

Amount of line 77 that you want applied to your 2025 

refund. 

estimated tax (see instructions) 

- 

79 

[ 

00] 

See instructions for payment 

80 

Amount you owe (if line 76 is less than 

line 62, 

subtract line 76 from line 62). To pay by electronic 

options. 

funds withdrawal, mark an x in the box 

[1 and fill in lines 83 and 84. If you pay by check 

or money order you must complete Form IT-201-V and mail it with your return... 

[ 

80] 

00] 

81 

Estimated tax penalty (include this amount in line 80 or 

reduce the overpayment on line 77) 

8t 

00] 

See instructions for the proper 

82 

Other penalties and interest 

82 

00 

assembly of your return. 

83 

Account information for direct deposit or electronic funds withdrawal 

| 

Business savings 

-or- 

Business checking 

- or - 

84 

Electronic funds withdrawal... 

Date 

Amount 

I 

.00 

Third-party 

Print designee's name 

Designee's phone number 

Personal identification 

designee? (see instr)| MARK LENSKI, 

CPA 

212 

697 8540 

number (PIN) 

ves[X] No 

Email. 

MARK .LENSKI@APRIO.COM 

03441 

W Paid preparer must complete (seeirsiuctons) 

W 

| Krom. 

Tees 03 

W 

Taxpayer(s) mustsign here 

YW 

OL SIHL NO ‘FHUNLYNDIS NVHL ¥FHLO ‘SFIMINI NILLISMANVH ON

Page 20

Michigan Department of Treasury 

. 

. 

2742 (Rev. 08-23) 

Local {Oltyounship} 

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 belo 

been denied. If you have questions about the denial, you may contact your local government or follow tl} 

appeal procedures specified below. For more information regarding the Principal Residence Exemption, 

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

Type or print i in blue or black ink 

bee tr— 

[ PART 1: PROPERTY INFORMATION Type or print legibly. Use a separate form fore each property number. 

1. 

Property tax identification number 

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

3. County 

01-16-33-201-003 

Ba™ Boar Creele | 

emmer 

4. 

Street address of property (Provide a Complete Address) 

1103 PARK AV 

5. 

Name of Owner (First, Middle, Last) 

6. Owner's Last Four Digits of Social Security Number 

7. 

Owner's Daytime Telephone Number 

BLUMKA LOIS E. 

- 

QL 

7- 498- 3303 

8. 

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

9. Co-Own: 

mber | 10. Co-Owner's Daytime Telephone Number 

XXX-XX- 

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: 

[J 

a. The owner is not a Michigan resident. 

Oa 

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

O 

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

[1] 

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

[0 

e. Other: 

13. 

Claim Denied for Calendar Year(s): 

14. 

Percentage Adjusted to: 

(see instructions) 

g 

202 

—— 

% 

PART 

2: CERTIFICATION 

HE 

Cant 

Sania 

: 

ES 

Foot 

io 

15. Name pf the Local Assessor 

(Print or Type) 

BINNS 

else 

a 

0k 

= y/o] Ty 

2: 2-24 

18. Address and ree 

ber of Local 

573 0. Dorion 

0) Lode Joc 4220 23347-41311 

19. 

Email Address 

of Assessor 

Sugerasal) bore reckoning R=Y 1% 

Homeowner's Right %. Appeal

Page 21

Asef 

JAI pS 

1 herchy certify that T have examined the records 

in my office and it appears that the taxes on the 

within description have been paid for the five year 

period pregeding the date of this document. 

Péloskey, MI 

ALNNOY 13WWI 

SS€ od S-933¢510 

SG330 40 Y3LSID3Y 

yy 

OFFICIAL SEAL 

Emnet Register 

of Deeds 

. 

Michele 

E Cooke 

62/2392015 98:38:19 AN 

YL: 1173 P: 871 

The Grantor: LOIS E. BLUMKA, 

whose address is 209 E. 72° ST., NEW YORK, NEW YORK 10021, 

conveys and 

to The Grantees: 

\YE. 

B 

UMK/ 

Lo rosa is 209 E. 72"° ST., NEW YORK, NEW YORK 10021, 

the following described property situated in the Township of Bear Creek, Emmet County, 

Michigan: 

— 

35 

WARRANTY DEED 

I€ 

| 

[sine 

sas STs 

Lots 8, 9, 12, the Easterly 1/2 of Lot 11 and the North 10.00 feet of Lot 

13, Block 1, VILLAGE OF EDGEWATER, according to the recorded Plat 

thereof as recorded in Liber 

4 of Plats, Page 4, Emmet County Records. 

» 

i 

Subject to easements, covenants and building and use restrictions of record, if any; 

€ 

*and 

Cou 

for the sum of less than $100.00. This deed is exempt from Michigan Stated Transfer Taxes 

pursuant to MCL 207.526a and MEKRNREPEX MCL 207.5051 

DATED: 

[frsts™ 

Ps 

oe 

J 

Pa 

) 

pp. 

; 

) 

JOSE Blam 

“= 

®h od 0293 

- 

STATE OF ew bok 

) 

COUNTY OF pips flank 

) 

Sf 

od 21838: 

Q3A1333Y 

INADJ 133A 

03AI1303Y 

3 

[7] 

— 

m 

EY) 

E 

8 

m 

[] 

Lg 

The foregoing WARRANTY DEED was acknowledged before me this 28 

day, January,” 

© 

2015, by LOIS E. BLUMKA. 

I 

) 

/ 

or 

Fn BEE 

p 

Rory Pull - Slate it New, York 

Notary Public 

iz fa 

1 ie 

S 

oo SortCounty, 

a 

My Goffolssiofr 

Expirey- 

Actingin _Akus fad 

County, 

4 

Des 

” 

* 

My Commission Expires: er 

: 

Matted 

ip New 

Yark 

When Recorded Return To: 

Send Subsequent Tax Bills To: Drafted By: Steven C. Cross 

GRANTEE 

GRANTEE 

Attorney at Law 

[oN

Page 22

TE 

RUT 

TR RTHRL 

BEAR CREEK TOWNSHIP 

"373 N. Division Road e Petoskey, MI 49770 

Michiga

Tax Tribu

611 West Ott

PO Box 3

Lansing, MI

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