Form 627 - Assessor Or Equalization Director'S Notice Of Property Incorrectly Reported Or Omitted From Assessment Roll

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L-4154/627
Michigan Department of Treasury
OFFICE USE ONLY
627, Formerly L-4154 (Rev. 10-08)
File Number
Assessor or Equalization Director's Notice of Property
Incorrectly Reported or Omitted From Assessment Roll
Assessment Unit Number
This form is issued under authority of Section 211.154, MCL.
INFORMATION FROM PERSON GIVING NOTICE
MUST BE TYPED OR PRINTED LEGIBLY
Name of Assessor or Equalization Director Filing this Notice
Telephone Number
Assessor Certification Number
Name of Assessing Unit
E-mail Address
Address (Number, Street, City or Post Office and ZIP Code)
PROPERTY AND ASSESSMENT ROLL INFORMATION
Name(s) of Property Owner(s)
Owner's Mailing/Contact Address (Number, Street, City, State and ZIP Code)
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 below)
Property Classification
Real Residential
Real Agricultural
Personal Industrial
Personal Residential
Real Industrial
Real Developmental
Personal Commercial
Personal Agricultural
Special Roll (PA 198, PA 255, PA 189)
Real Commercial
Real Timber-cutover
Personal Utility
Property Description
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 making the assessment that was confirmed by the Board of Review?)
OR
Estimated/Not filed? If estimated or not filed, indicate years: ___________________________________
Is this property assessed on the Industrial Facilities Tax Assessment Roll, the Commercial Facilities Tax Assessment Roll, the Technology Park
Facilities Assessment Roll, the Neighborhood Enterprise Zone Assessment Roll, the Renaissance Zone assessment or as an Act 189 of 1953
assessment?
Yes
No
If yes, specify which roll:___________________________________________
Assessed Value
Taxable Value
Year(s) For Which
Assessed Value on
Requested Assessed
Year(s) For Which
Taxable Value on
Requested Taxable
Notice Was Given
Assessment Roll
Value
Notice Was Given
Assessment Roll
Value
STC Date Stamp
REASON FOR THIS NOTICE: This form will not be processed if the information/documentation requested in
this space is not provided. Attach relevant supporting information. Include a copy of the timely-filed personal
property statement and the amended personal property statement. Provide a record card or other
documentation showing that omitted real property was not previously included in the assessment.
State Tax Commission
Continue and sign on page 2.
Michigan Department of Treasury
P.O. Box 30471
Lansing, MI 48909-7971

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