Assessor Or Equalization Director'S Notice Of Property Incorrectly Reported Or Omitted From Assessment Roll Form Page 2

Download a blank fillable Assessor Or Equalization Director'S Notice Of Property Incorrectly Reported Or Omitted From Assessment Roll Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Assessor Or Equalization Director'S Notice Of Property Incorrectly Reported Or Omitted From Assessment Roll Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

627, Page 2

TAX RATE INFORMATION (to be completed by the assessor)

If this notice is for either or both of the tax years immediately preceding the current year, the assessor shall list for each year covered

by this notice the total tax rate levied in the city or township in which the property is located. The total annual tax rate levied must

include the total village tax rate, if applicable. If this notice is for omitted real property upon which "millage rate" special assessments

were levied, list those rates separately below. Do not include special assessments levied in specific dollar amounts.

Year Covered By Notice

SUMMER Total Tax Rate Levied

WINTER Total Tax Rate Levied

Total Annual Tax Rate Levied

SPECIAL ASSESSMENT RATES. Complete lines below for special assessment millage rates only

Year Covered By Notice

SUMMER Special Assessment

WINTER Special Assessment

Total Annual Special Assessment

Rate Levied

SIGNATURE

Signature of Assessor or Equalization Director

Date

INSTRUCTIONS: The State Tax Commission's jurisdiction under MCL 211.154 is limited to correcting assessments for the current

assessment year (the year of discovery and disclosure to the Commission) and two immediately preceding years. Although you must

present a copy of this form to the property owner for concurrence or disagreement, you may also immediately submit a second copy of

this form, without the owner's concurrence or disagreement, to the State Tax Commission. Your failure to do so by December 31 of

the current calendar year may affect the Commission's jurisdiction to consider all of the assessment years that you have included on

this form.

OWNER'S CONCURRENCE OR DISAGREEMENT WITH THIS REQUEST

This section shall be completed by the property owner and the form returned to the assessor.

I concur (agree) with this request for corrected Assessed Value and/or Taxable Value.

I do not concur with this request for corrected Assessed Value and/or Taxable Value. The owner who checks this box must submit to the

assessor an explanation of the reason for not concurring.

Comments or Explanations

Did the property covered by this notice change ownership during the time period starting with the earliest year for which a change is being requested,

up to the present?

If yes, give date.

Yes

Signature of Property Owner

Date

Telephone Number

Email Address

Assessors must send this completed form to:

The State Tax Commission

Michigan Department of Treasury

PO Box 30471

Lansing, MI 48909-7971