Clear form
Before the Utah State Tax Commission
Petition for Expedited Hearing
PETITIONER:
PETITIONER’S REPRESENTATIVE (if any):
Name: ____________________________________________
Name:_______________________________________________
Daytime Phone: ____________________________________
Daytime Phone: _______________________________________
FAX: ____________________________________________
FAX: _______________________________________________
Mailing Address: ___________________________________
Mailing Address: ______________________________________
_____________________________________________
________________________________________________
-
I authorize the above
named person to discuss this
Appeal with the Utah State Tax Commission.
Yes
No
PRIMARY ISSUE:
This appeal involves an assessment, decision, or action by:
Property Tax Division
Taxpayer Services Division
Motor Vehicle Enforcement Division
Auditing Division
Motor Vehicle Division
Other
Describe the primary issue:
Factor Order
Certified Tax Rate
Suspension or Denial of a License
Other (explain)
Reason for requesting expedited hearing:
If this appeal results from a decision, letter, assessment, or notice issued by a Division of the Tax Commission, state the date of that action
and the name of the Division which took the action. (Attach a copy of the decision letter, assessment or notice to this form.)
_____ / _____ / _____ __________________________________________________________________________________________
Date
Division
Section 59-1-502.5 of the Utah Code entitles the petitioning party to an Initial Hearing, with rights to pursue the matter further in
a Formal Hearing. As the petitioning party, you may waive your right to the Initial Hearing and proceed directly to the Formal
Hearing. Indicate your preference:
I waive the Initial Hearing
I request an Initial Hearing
REQUEST FOR RELIEF:
Describe the basis for your appeal and the relief that you seek from the Tax Commission (attach additional pages if necessary):
Petitioner’s signature: ______________________________________________________
Date: ______________________________
The Tax Commission Appeals Unit will accept all written submissions by email, mail, or fax:
Utah State Tax Commission
Appeals Unit
210 North 1950 West
SLC, UT 84134
Fax: 801-297-3919
Email: taxappeals@utah.gov
TC-739 Rev. 5/15