Form 2742 - Notice Of Denial Of Principal Residence Exemption - 2013
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Michigan Department of Treasury
Local (City/Township)
2742 (Rev. 05-13)
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 has been denied. If you have
questions about the denial, you may contact your local government or follow the appeal procedures specified below.
Property Information
Type or print legibly. Use a separate form for each property number.
1. Property Tax Identification Number
2. Zip Code
3. Street Address of Property
4. Name of Township or City
5. County
Township
City
6. Name of Owner (First, Middle, Last)
7. Owner's Social Security Number
8. Name of Co-Owner (First, Middle, Last)
9. Co-Owner's Social Security Number
10. Mailing address if different than property address (street or RR#, city, state, Zip Code)
Your exemption was denied/adjusted for the following reason:
11.
a. The owner is not a Michigan resident.
b. The property claimed is not the owner's principal residence.
c. The person claiming the exemption is not the owner.
d. Other:
12. Claim Denied for Calendar Year(s):
13. Percentage Adjusted to:
(see instructions)
%
Certification
Date
14. Signature of Local Assessor or Board of Review
Assessor
Board of Review
15. Address and Phone Number of Local Government
Homeowner's Right to Appeal
If you disagree with this denial, you may appeal to the Residential/Small Claims Division of the Michigan Tax Tribunal
within 35 days of the denial. An appeal with the Michigan Tax Tribunal can be initiated by the timely filing of a petition.
The petition must be a Michigan Tax Tribunal form or a form approved by the Michigan Tax Tribunal. Michigan Tax
Tribunal forms are available at You can print the Petition for Denial of Exemption for
Principal Residence/Qualified Agricultural and mail the completed form to the Michigan Tax Tribunal at P.O. Box 30232,
Lansing, Michigan 48909 or complete the form online and submit electronically, if provided for by the Michigan Tax
Tribunal.
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