5107 State Tax Commission Affidavit For Disabled

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Michigan Department of Treasury
5107 (12-13)
State Tax Commission Affidavit for Disabled Veterans Exemption
Issued under authority of Public Act 161 of 2013, MCL 211.7b. Filing is mandatory

Instructions: This form is to be used to apply for an exemption of property taxes under MCL 211.7b, for real property used and owned as a homestead by
a disabled veteran who was discharged from the armed forces of the United States under honorable conditions or his or her unremarried surviving spouse

The property owner, or his or her legal designee, must annually file the Affidavit with the supervisor or assessing officer any time after December 31 and
before, or until the conclusion of, the December Board of Review

OWNER INFORMATION (Enter information for the disabled veteran or unremarried surviving spouse)
Owner’s Name Owner’s Telephone Number
Owner’s Mailing Address
City State ZIP Code
LEGAL DESIGNEE INFORMATION (Complete if applicable)
Legal Designee Name Daytime Telephone Number
Mailing Address
City State ZIP Code
HOMESTEAD PROPERTY INFORMATION (Enter information for the property in which the exemption is being claimed)
City, Township or Village (Check the appropriate box and provide the name) City Township Village
County Name of the Local School District
Parcel Identification Number Date the Property was Acquired (MM/DD/YYYY)
Homestead Property Address
City State ZIP Code
ACKNOWLEDGEMENT (Check all boxes that apply)
I am a disabled veteran, or the legal designee of the disabled veteran, who was discharged under honorable conditions from the armed forces of
the United States of America with a service connected disability

I am the unremarried surviving spouse, or the legal designee of the unremarried surviving spouse, of a disabled veteran who was discharged
under honorable conditions from the armed forces of the United States of America with a service connected disability

I am a Michigan resident

I own the property in which the exemption is being claimed and it is used as my homestead. Homestead is generally defined as any dwelling with
its land and buildings where a family makes its home

AFFIRMATION OF ELIGIBILITY (Check the appropriate box and provide a copy of the required documentation)
The disabled veteran has been determined by the United States Department of Veterans Affairs to be permanently and totally disabled as a result
of military service and entitled to veterans’ benefits at the 100% rate (must attach a copy of the letter from the U.S. Department of Veterans Affairs)

The disabled veteran is receiving or has received pecuniary assistance due to disability for specially adapted housing (must attach a copy of the
certificate from the U.S. Department of Veterans Affairs)

The veteran has been rated by the United States Department of Veterans Affairs as individually unemployable (must attach a copy of the letter
from the U.S. Department of Veterans Affairs)

CERTIFICATION
I hereby certify to the best of my knowledge that the information provided in this Affidavit is true and I am eligible to receive the disabled veteran’s
exemption from property taxes pursuant to Michigan Compiled Law, Section 211.7b

Printed Name of Owner or Legal Designee Title of Signatory
Signature of Owner or Legal Designee Date
DESIGNEE MUST ATTACH LETTER OF AUTHORITY

Michigan Department of Treasury 5107 (12-13) State Tax Commission Affidavit for Disabled Veterans Exemption Issued under authority of Public Act 161 of 2013, MCL 211.7b. Filing is …

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Frequently Asked Questions

What is the state tax commission affidavit for disabled veterans exemption?

5107, State Tax Commission Affidavit for Disabled Veterans Exemption Michigan Department of Treasury 5107 (12-13) State Tax Commission Affidavit for Disabled Veterans Exemption Issued under authority of Public Act 161 of 2013, MCL 211.7b. Filing is mandatory.

What is da form 5106?

What Is DA Form 5106? This is a military form that was released by the U.S. Department of the Army (DA) on January 1, 2013. The form, often mistakenly referred to as the DD Form 5106, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

When to file form 510d?

When to File File Form 510D on or before the 15th day of the 4th, 6th, 9th and 12th months following the beginning of the tax year or period for S corporations or by the 4th, 6th, 9th and 13th months following the beginning of the tax year for partnerships, LLCs and business trusts.

What is an i 751 affidavit?

Form I-751 is a form used to remove conditions on residence for conditional residents who obtained status through marriage. Both forms are important, but different. However, the process for writing affidavits for them is fairly similar. The goal of an affidavit is for a third party to support evidence that the marriage is a bona fide marriage.