Real Estate Assessment Appeal Application - Fairfax County Real Estate Division - 2016

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2016 REAL ESTATE ASSESSMENT APPEAL
APPLICATION
Tax Map Reference Number
Department Of Tax Administration (DTA)
Fairfax County Real Estate Division
__ __ __ __ __ __ __ __ __ __ __ __ __ __
12000 Government Center Parkway, Suite 357
Fairfax, Virginia 22035
DTA USE ONLY NBHD #:
Telephone: 703-222-8234; TTY 711
Appeal Number: ___________________________
E-mail:
Internet:
Assigned to Appr: ____ Date Due: ___/___ /_____
APPEAL DEADLINE IS APRIL 4
Appeals received after the deadline will not be processed until the coming year’s assessment review is complete.
Address of Property Being Appealed:
Property Location (City):
Property Zip Code:
Building Name (if any):
Name of owner (s) on Jan. 1, 2016:
2016 Assessment Notice Values: Land:
Building:
Total:
Under state law, financial impact and/or the rate of value change is not sufficient grounds for appeal. As
required, the county’s assessment is an estimate of fair market value as of Jan. 1, 2016. Appeals should
be based on at least one of the three categories noted below. Check one or more for your appeal basis.
FAIR MARKET VALUE: This property is assessed greater or less than its Fair Market Value as indicated by a review of
comparable properties (see reverse side of form).
LACK OF UNIFORMITY: This property assessment is out of line generally with similar properties (see reverse side of form).
ERRORS IN PROPERTY DESCRIPTION: Assessment is based upon inaccurate information concerning this property such
as lot size, square footage, condition of property, flood plain, topography, zoning, etc. (List accurate property characteristic
details on the reverse side of this form).
):
OWNER/APPLICANT INFORMATION (must be completed by all owners or applicants
Based on this appeal information, I believe the proper assessment of this property as of Jan. 1, 2016 should be:
Land:
Building:
Total:
I hereby certify that the facts contained herein and attached hereto are
If applicant is not the owner of record, application must include a
true, accurate and correct to the best of my knowledge and belief.
Letter of Authorization from the owner, signed prior to date of
application, either notarized or on owner’s commercial
Given under my hand this ______ day of __________________, 20___
letterhead. Two most recent annual income/expense surveys
Signature of Applicant/Owner:_________________________________
along with current rent roll must be submitted with appeals on
income producing properties.
Print name of Applicant/Owner : _______________________________
Phone: Day (
) _________________ Other (
) ________________ E-Mail ______________________________________
Applicant/Owner Mailing Address (if different from property address): __________________________________________________
__________________________________________________________________________________________________________
C
O
:
I
I
AM THE OWNER OF RECORD
AM NOT THE OWNER OF RECORD
HECK
NE
CONTINUED ON REVERSE SIDE
Revised 01/2016

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