Mich. Admin. Code R 205.905 — Initiation of a proceeding

Rule 5. (1) A proceeding shall be initiated by filing with the commissioner
of revenue a notice of appeal by petition as provided in R 205.904, and substantially
in accordance with the form hereinafter set forth.
(2) The petition shall be complete in itself so as to fully state the
issues and shall contain the following:

STATE OF MICHIGAN DEPARTMENT OF REVENUE
_____________________________________________________________________
_____

________________________________________ Appellant
vs. DOCKET NO.

City of ________________________________ Appellee
_____________________________________________________________________
_____

PETITION

TO THE STATE COMMISSIONER OF REVENUE:
The above-named appellant hereby petitions for a redeter mination of the (final
assessment, denial in whole or part of a claim for refund, special ruling, adoption of a
rule or regulation by the administrator) set forth by the City of ________ in its
determination, decision or order dated ______, 19 ______ and as a basis of his
proceeding alleges as follows:
1. The appellant is (set forth whether individual, corporation, etc.) with principal
office or residence at ____________________________________.
(Street) (City) (State)

2. The matter in controversy is
______________________________________________
_____________________________________________________________________
_____
_____________________________________________________________________
_____
_____________________________________________________________________
_____
_____________________________________________________________________
_____

3. The determination, decision or order is based upon the following errors:
(Enumerate specifically the as signments of error in a concise manner and avoid
pleading facts which properly belong in the succeeding paragraph.) Copy of said
determination, decision or order is hereto attached and marked exhibit A.
4. The facts upon which the appellant relies as the basis of this proceeding are
as follows:
(Here set forth allegations of facts relied upon, the prior legal steps taken by the
petitioner, in orderly and logical sequence, with subparagraphs lettered, so as to
inform the commissioner of revenue of the issues to be presented and to enable the
city to admit or deny each specific allegation.) Wherefore, the appellant prays that the
commissioner of revenue may hear the proceedings and (state the relief desired).
Signed ___________________________ Appellant

___________________________ Address

State of ____________________________________
County of _________________________________

_________________________, being duly sworn, says tha t he is the petitioner (if a
corporation, or fiduciary, state title of office or trust of person verifying and that he is
duly authorized to verify the foregoing petition) above named; that he has read the
foregoing petition, or had the same read to him, and is familiar with the statements
contained therein, and that the statements contained therein are true, except those
stated to be upon information and belief, and that those he believes to be true.

Signed ____________________________

Subscribed and sworn to before me this ________day of ___________, 19____
Signed __________________________________
(Official title)

(Seal)