Form 629 - Notice Of Property Incorrectly Reported Or Omitted From The Assessment Roll Filed By A Person Other Than The Owner, Assessor Or Equalization Director
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L-4156/629
Michigan Department of Treasury
OFFICE USE ONLY
629 (Rev. 10-08) Formerly L-4156
Notice of Property Incorrectly Reported or Omitted
File Number
From the Assessment Roll Filed by a Person Other
Assessment Unit Number
Than the Owner, Assessor or Equalization Director
This form is issued under authority of Section 211.154, MCL.
INFORMATION FROM PERSON GIVING NOTICE
MUST BE TYPED OR PRINTED LEGIBLY
Property Omitted or Incorrectly Reported
Property Owner (If Known)
Name of Property Owner(s)
Type of Property (Please Describe)
Owner's Address (No. and Street, City, ZIP)
Property Location:
Address (No. and Street, City, ZIP) or (Legal)
Name & Address of Person Giving Notice
Description of Place(s) where property is located
Name
Address (No. and Street, City, ZIP)
Daytime Phone Number
Email Address
Signature & Certification of person giving notice
The undersigned certifies that the above information is correct to the best of his or her knowledge and belief
Signature
Date
PROPERTY AND ASSESSMENT ROLL INFORMATION (To be completed by State Tax Commission)
County where property is located
City or Township or Village and Township
School District
Intermediate School District
Community College District
Property Index Number/Parcel Code (Or enter property description under Findings below)
Property Classification
PERSONAL PROPERTY NOTICES ONLY: Did the owner complete and deliver a personal property statement (L-4175) for each year that this notice
covers that was:
Timely Filed? (Accepted as filed and actually used in the assessment that was confirmed by the Board of Review?)
OR
Estimated/Not filed? If estimated or not filed, indicate years:______________________________
Assessed Value
Taxable Value
Assessed Value on
Year(s) for Which
Requested
Year(s) for Which
Taxable Value on
Requested
Assessment Roll
Notice Was Given
Assessed Value
Notice Was Given
Assessment Roll
Taxable Value
Signature of Chairperson/Executive Secretary, Michigan State Tax Commission
Date
STC Date Stamp
Michigan State Tax Commission Findings.
For incorrectly reported personal property, include a copy of the timely filed personal property statement
and the amended personal property statement. For omitted real property, provide a record card or other
documentation showing that the omitted real property was not previously included in the assessment.
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