PROPERTY INFORMATION

A.	Purchase date	___________________ 	Amount paid  _____________________

B.	Mortgage/ land contract balance	     _____________________________________

C.	Monthly payment ___________________

	Does this payment include taxes?  		Yes________ 	No________

D.	Number of years remaining on mortgage/land contract	  ________________

E.	Are your property taxes paid?  			Yes________ 	No________

F.	Did you apply for a poverty exemption 		Yes________ 	No________
	last year?

G.	Do you have ownership interest in any other real estate in Michigan or 
	anywhere else?
	 						Yes________ 	No________
 
	If yes, please list: 

	Location: __________________________ Tax ID No. __________________________
	
	SEV 	  __________________________ Purchase date   _____________________

	Purchase date

H.	Are you or your spouse the sole owners of the subject property $

		Yes________ 	No________

J. 	Have any improvements, changes or additions been made to the property in 
	the last two (2) years?

		Yes________ 	No________
	
	Explain  _________________________________________________________________

K.	Do you anticipate selling the homestead property for which relief is sought 
	in the next year?

		Yes________ 	No________

	Explain  _________________________________________________________________

L.	Does anyone contribute to your support? 	Yes________ 	No________

	Explain

M.	Is anyone able to contribute to your support? 	Yes________ 	No________