Form 2742 - Notice Of Denial Of Principal Residence Exemption - 2013 Page 2
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1
2Instructions for Form 2742
Notice of Denial of Principal Residence Exemption
Local (City/Township)
Line 10: Enter the mailing address if it is different from the
General Instructions
address on line 3.
This form is for local assessors and local boards of review
Line 11: Check the box indicating the reason the principal
to use when notifying a homeowner that his or her principal
residence exemption was denied. If none apply, check
residence exemption is denied. It will also be used to notify
"other" and enter a more detailed explanation of your
the Department of Treasury of the denial. Complete all
reasons for denial. Be specific and as complete as possible.
information carefully and accurately to avoid processing
The information you provide in this section may be used in
errors.
the appeals process.
Mail a copy to Treasury with a copy of Form 2753, Batch
Line 12: Enter all years that are being denied. (You have the
Cover for Principal Residence Exemption. Label them as
authority to deny the current year and the three preceding
denials.
years.)
Mail the original to the homeowner. Appeal rights are
Line 13: Enter the percentage to which the principal
printed on the bottom of the form. Make a copy for your
residence exemption has been adjusted.
records.
Line 14: This form must be signed by either the local
Line-by-Line Instructions
assessor or the secretary of the board of review. Indicate
IMPORTANT: Complete a separate form for each
who is denying exemption.
property being denied.
Line 15: The homeowner has only 35 days to appeal an
Line 1: You must complete this line. Do not enter more than
exemption denial. The date you enter here is the starting
one property identification number (PIN) on each form. The
date for the homeowner's appeal time. Mail all forms the
PIN should be identical to the number used on the original
day they are signed.
affidavit.
Line 16: Enter the address and telephone number of the
Lines 2-5: Enter the complete address of the property you
proper contact person at the local government.
are claiming. Enter name and check the appropriate box
Additional Forms or Questions?
for the city or township in which the principal residence is
located.
This form is available on Treasury's Web site at
Lines 6-9: Enter the name and social security number(s) of
the legal owner(s) that occupy the property.
If you have questions call 517-373-1950.
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