Real Estate - Account Filing Per Rigl 44-5-15 Form - Town Of West Greenwich printable pdf download

Town of West Greenwich

TAX YEAR 2016

Real Estate – Account Filing per RIGL 44-5-15

This form must be filed between January 1, 2016 & January 31, 2016. Incomplete forms will be returned. An

extension request may be requested in writing between 1/1 and 1/31 in which case this form must then be filed

between March 1, 2016 and March 15, 2016.

PROPERTY OWNER’S NAME ___________________________________________________________

NAME OF AUTHORIZED AGENT ________________________________________________________

MAILING ADDRESS __________________________________________________________________

PHONE NUMBER: ________________________

EMAIL: __________________________________

PROPERTY LOCATION: ________________________________________________________________

PLAT / LOT: ________________________

ACCOUNT NUMBER: ____________________

Current Assessed Value:

Insured Value:

Fair Market Value:

Based on:

Appraisal / Real Estate Broker / Owner’s Estimate

If there has been a change in the overall condition of your real estate, please explain below detailing those changes

(attach applicable photographs). If there has been a change in the usage of your real estate (single family to two

family, etc.) please explain below detailing those changes. If there is an error on your property record card, please

explain below specifying the error and copy and sign the field card.

_____________________________________________________________________________________________

APPLICANT’S CERTIFICATION

I certify, under penalty of perjury, that the above listed information is to the best of my knowledge a true and exact

account of all ratable estate owned or possessed by me. Any misrepresentation of these facts may result in a loss of

your appeal rights in the Town of West Greenwich, or in Rhode Island Superior Court, should the undersigned so

choose to appeal to that level.

Sign Name Here:

______________________________________

Print Name Here:

______________________________________

Date:

______________________________________

NOTARY PUBLIC

State of Rhode Island; County of ______________________

Subscribed and sworn to before me at ________________ this ______ day of __________________ 20 ___

My commission expires ______________

Signature of Notary _______________________________

Real Estate - Account Filing Per Rigl 44-5-15 Form - Town Of West Greenwich