Letter Of Agent Authorization Form - Office Of Tax & Revenue printable pdf download

GOVERNMENT OF THE DISTRICT OF COLUMBIA

OFFICE OF THE CHIEF FINANCIAL OFFICER

OFFICE OF TAX & REVENUE

LETTER OF AGENT AUTHORIZATION

This letter authorizes _________________________________(owner/designated agent), located at

________________________________________(address) and (_______) _____-__________(phone),

to act in my/our behalf as agent in all matters pertaining to the ad valorem tax and/or assessment on real property

located in the District of Columbia, described below, and to review any and all documents relating to the

assessment and taxation of the property. Specifically, this property is described as:

Square ____________ Lot ____________

Address ______________________________________________

Owner of Record ______________________________________

This letter of agent authorization pertains to Tax Year _________ only.

This letter of agent authorization grants the authority to the agent named above to request and examine confidential

records, discuss any appeal, and to agree to and sign a binding stipulation agreement with the Office of Tax and

Revenue regarding the ad valorem tax and/or assessment on the above described property at any time prior to

filing a petition with the Tax Division of the Superior Court of the District of Columbia.

If this letter of agent authorization is signed by an individual purporting to represent an organization (corporation,

partnership, etc.) as the owner of record, documents exhibiting authority of that individual to sign on behalf of the

organization must be attached and made part of this letter of agent authorization. The filing of the Letter of Agent

Authorization automatically revokes all previous agent authorizations with the Office of Tax & Revenue for the

years covered by this document and will remain in effect until the owner of record revokes it in writing.

Submission of false statements is subject to criminal penalty. D.C. Code §22-2514.

Owner's Signature __________________________________________________

Name (printed) _____________________________________________

Title ______________________________________________________

Telephone Number _______-_______-___________________________

Date _______________________________________________________

NOTARIZATION (Required for Commercial Properties and/or where confidential information is requested)

I, ____________________, a Notary Public in and for the ____________________, do hereby certify that

____________________(Name), as ____________________(Title) of ____________________(Owner of Record),

personally appeared before me and acknowledged that this "Office of Tax and Revenue Letter of Agent

Authorization" was executed for the purpose herein expressed.

WITNESS MY HAND AND SEAL this __________ day of __________, 20___.

__________________________(SEAL)

My Commission Expires _______________, 20___

(Notary Public)

ONLY ORIGINAL DOCUMENTS WILL BE ACCEPTED

_________________________________________________________________

Rev (03-19-02 RPAD)

Letter Of Agent Authorization Form - Office Of Tax & Revenue