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MAUFACTURED HOME
COMMERCIALINDUSTRIAL
Authorization Attached
owner occupied yes
owner occupied no
SINGLE-FAMILY RESIDENCE, CONDOMINIUM, OR TOWNHOUSE
AGRICULTURAL
POSSESSORY INTEREST
APARTMENTS NUMBER OF UNITS
VACANT LAND
WATER CRAFT
AIRCRAFT
BUSINESS PERSONAL PROPERTYFIXTURES
OTHER
REGULAR ASSESSMENT
SUPPLEMENTAL ASSESSMENT
PENALTY ASSESSMENT
Value of construction in progress on January 1 is incorrect
2 Only a portion of the personal propertyfixtures Attach description of those items
CHILD
ROLL CHANGE
ESCAPE ASSESSMENT
CALAMITY REASSESSMENT
Decline in value
No change in ownership occurred on the date of
Base year value for the change in ownership established on the date of
No new construction occurred on the date of
Base year value for the new construction established on the date of
Calamity Reassessment
1 All personal propertyfixtures
Penalty assessment is not justified
1 Classification of property is incorrect
2 Allocation of value of property is incorrect
1 Amount of escape assessment is incorrect
2 Assessment of other property of the assessee at the location is incorrect
Explanation attached
Are requested
Are not requested
Yes claim for refund_yes
No claim for refund
Signature HereClick to Sign
OWNER1
AGENCY
ATTORNEY
SPOUSE
REGISTERED DOMESTIC PARTNER
PARENT
PERSON AFFECTED
CORPORATE OFFICER OR DESIGNATED EMPLOYEE
x

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