Form 2368 (Formerly T-1056) - Homestead Exemption Affidavit

Michigan Department of Treasury

Issued under P.A. 237 of 1994

2368 (Rev. 6-99)

Filing is required if you wish to receive

Formerly T-1056

an exemption

HOMESTEAD EXEMPTION AFFIDAVIT

An affidavit filed by an owner for a Homestead Exemption rescinds all previous exemptions filed by that owner. This form must

be filed with the assessor for the city or township where the property is located.

Property Information (Always complete this section)

Type or print legibly. Use a separate form for each property number.

>1.

Property tax identification number

>2-4.

Address of property

>5.

County

6. Enter the date the property in number 1 above became your homestead……………………………………6.

The property in number 1 above is my: >6a. _____Principal residence

>6b. _____Residential vacant contiguous or adjacent lot

>7. Name of Owner (first, middle, last)

>8. Owner’s Social Security Number

>9. Name of Co-Owner (first, middle, last)

>10. Co-Owner’s Social Security Number

11. Property owners daytime phone number (_______)___________________________________

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

(your principal residence) occupies. Your exemption will be based on this percentage……………….………12.____________

13. Have you claimed a homestead exemption for another Michigan homestead?…………………………………13. _____Yes_____No

14. If yes, have you rescinded that homestead exemption?…………………………………………………………14. ______Yes____No

Certification – (Read Carefully)

I certify, under penalty of perjury, that I own (co-own) and occupy the property claimed on this affidavit as my principal residence, that

I am filing an affidavit for only one dwelling, and that all information is true to the best of my knowledge.

15. Owner’s Signature

Date

16. Co-Owner’s Signature

Date

_____________________________________________________

____________________________________________________

17. Mailing address if different than property address (street or RR#, city and ZIP)

______________________________________________________________________________________________________________

18. Closing Agent or Preparer’s Name & Mailing Address

Do not write below this line – Local Government Use Only

19. Was an exemption in place prior to this affidavit being filed?………………………………..19. _____Yes_____No

20. What is the first year you will post this exemption to the tax rolls?…………………………..20. Year____________

21. Indicate property classification________________________

HOMEEXAFF.doc

Form 2368 (Formerly T-1056) - Homestead Exemption Affidavit - 1999

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