Appointment Of Agent
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1OFFICE OF THE ASSESSOR
BOB DUTTON
Assessor-Recorder-County Clerk
172 West Third Street
San Bernardino, CA 92415-0310
(909) 387-8307 ● 1 (877) 855-7654
A
A
PPOINTMENT OF
GENT
Full Legal Name of Owner
O
Mailing Address
City
State
Zip Code
W
N
E
Physical Address
City
State
Zip Code
R
(
)
-
Contact Person and Title
Telephone Number
All property listed for this owner in San Bernardino County
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All Real property listed for this owner in San Bernardino County
R
All Business and Personal Property listed for this owner in San Bernardino County
O
P
Other:
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R
T
Y
General power to represent the owner in property tax matters concerning this property.
The Agent has specific powers listed below:
A
Filing of Assessor’s forms
A
U
File Assessment Appeal applications and represent owner at appeal hearings
G
T
Receive confidential information
E
H
Negotiate and resolve assessment matters
N
O
Change mailing address of all my property tax notices and other communications for this
’
T
R
property, including appraisal notices, appraisal review board orders and hearing notices,
S
I
tax bills, and collection notices
T
Note: These notices can affect your legal rights. The affected offices are not required by law to
Y
send you duplicate copies.
Other:
Agent’s Name:
A
Mailing Address
City
State
Zip Code
G
E
Physical Address
City
State
Zip Code
N
T
(
)
-
Contact Person and Title
Telephone Number
Authorization
Signature of Owner, a partner, or LLC Manager/Corporation Officer whom
Date
the Board of Directors has designated in writing to sign on behalf of the
Corporation.
Please print the Name and Title of the person above.
AEO 011 Rev. (01-15)
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Parent category: Legal