Form 2368 - Homeowner'S Principal Residence Exemption Affidavit - 2007
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2Michigan Department of Treasury
Reset Form
2368 (Rev. 4-07)
Homeowner's Principal Residence Exemption Affidavit
Issued under authority of P.A. 105 of 2003.
Completion of this affidavit constitutes a claim for a Homeowner’s Principal Residence Exemption when filed with the local assessor of
the city or township where the property is located. Filing this affidavit invalidates any previous Homeowner’s Principal Residence
Exemption the homeowner may have claimed. A Request to Rescind Homeowner’s Principal Residence Exemption, Form 2602 must
be filed with the local assessor for any previous claims.
Print or type in blue or black ink. Use a separate form for each property number.
Property Information
1.
2.
Property Tax Identification Number
ZIP Code
3.
4.
5.
Street Address of Property
Name of Township or City
County
Township
City
6. Date the property in line 1, above, became your principal residence
6.
Month
Day
Year
Principal residence
The property in line 1 above is my:
6a.
Residential vacant contiguous or adjacent lot
6b.
7.
8.
Name of Owner (First, Middle, Last)
Owner's Social Security Number
9.
10.
Name of Co-Owner (First, Middle, Last)
Co-Owner's Social Security Number
11. Property owner's daytime telephone number
11.
12. If this parcel has more than one home on it, or if you own and live in one unit of a multiple-unit
dwelling (or a multi-purpose property) give the percentage of the entire property that your unit
%
12.
(your principal residence) occupies. Your exemption will be based on this percentage
13.
13. Have you claimed a principal residence exemption for another Michigan principal residence?
Yes
No
14.
14. If yes, have you rescinded that principal residence exemption?
Yes
No
15. Do you or your spouse claim an exemption, credit or deduction on property located in
15.
Yes
No
another state?
16.
16. Have you or your spouse filed a tax return as a resident of another state?
Yes
No
Certification
I certify under penalty of perjury the information contained on this document is true and correct to the best of my knowledge.
17. Owner's Signature
Date
17a. Co-Owner's Signature
Date
17b. Mailing Address, if Different than Property Address Above
18. Closing Agent or Preparer's Name and Mailing Address
Local Government Use Only -- Do Not Write Below This Line
19.
19. Was an exemption in place prior to this affidavit being filed?
20.
20. What is the first year this exemption will be posted to the tax rolls?
21.
21. Indicate property classification
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