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Michigan Department of Treasury, PTD
2168 (Rev. 10-02)
Formerly L-4100 R Petition No.
Year
Assessor's Response to Petition for
Change of Property Classification
INSTRUCTIONS: The attached petition has been filed with the State Tax Commission as provided by MCL 211.34c, which was enacted by P.A. 381 of
1978, as amended by P.A. 476 of 1996. The certified assessor of the assessment unit where the petitioned property is located is required to respond to
the petition and to recommend the correct classification in accordance with the definitions set forth in MCL 211.34c, as amended. Please review the
petition and provide comment and explanation for each item where you are in disagreement with the petitioner.
1. Assessor's Recommended Classification 2. Parcel Zoned As:
3. Assessor's Comments (Attach additional sheets if needed):
ASSESSOR'S CERTIFICATION
4. I, _______________________________________, the certified assessor for the __________________________ of
(Township or City)
___________________________________ in ______________________________________ County have reviewed
(State)
the property which is the subject of the attached petition for change of property classification and hereby depose and
say that the foregoing response is full, true and correct.
Signature of Assessing Officer Assessing Officer Telephone Number
Certification No. Date
Return to: State Tax Commission
Michigan Department of Treasury
P.O. Box 30471
Lansing, Michigan 48909-7971
Fax: (517) 241-2621
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