_______________
BOR NO.
DATE RECEIVED
DTE FORM 1M (Prescribed 01/02)
R.C. 4503.06, 5715.13, 5715.19
COMPLAINT AGAINST THE VALUATION OF A
MANUFACTURED OR MOBILE HOME
TAXED LIKE REAL PROPERTY
ANSWER ALL QUESTIONS AND TYPE OR PRINT ALL INFORMATION
READ INSTRUCTIONS ON BACK BEFORE COMPLETING FORM
ATTACH ADDITIONAL PAGES IF NECESSARY
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TAX YEAR ________
ORIGINAL COMPLAINT
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C
OUNTY _______________________________
COUNTER-COMPLAINT
NOTICES WILL BE SENT ONLY TO THOSE NAMED BELOW
Name
Street Address, City, State, Zip Code
1) Owner of home
2) Complainant if not owner
3) Complainant's agent
4) Telephone number of contact person (
)
5) Complainant's relationship to property if not owner
If more than one home is included, see "Multiple Homes" on back.
6) Registration number from tax bill
Address of property
7) Principal use of property:
8) The increase or decrease in taxable value sought. Counter-complaints supporting auditor's value may have zero in Column D.
Registration Number
Complainant's Opinion of Value
Column C
Column D
Column A
Column B
Current Taxable Value
Change in Taxable Value (+ or -)
True Value
Taxable Value
(From Tax Bill)
(Col. B minus Col. C)
(Fair Market Value)
(35% of Column A)
9) The requested change in value is justified for the following reasons:
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10) Was home sold within the last 3 years? Yes
No
Unknown
. If yes, show date of sale ____________________and sale
price $_________________; and attach information explained in "Instructions for Question 10" on back.
11) If home was not sold but was listed for sale in the last 3 years, attach a copy of listing agreement or other available evidence.
12) If any improvements were added in the last 3 years, show date _______________________ and total cost $ ______________________.
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13) Do you intend to present the testimony or report of a professional appraiser? Yes
No
Unknown
.
14) If you have filed a prior complaint on this home since the last reappraisal or update of property values in the county, the reason for the
Valuation change requested must be one of those below. Please check all that apply and explain on attached sheet. See R.C.
5715.19(A)(2) for a complete explanation.
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The home was sold in an arm's length transaction;
The home lost value due to a casualty;
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A substantial improvement was added to the home.
Occupancy change of at least 15% had a substantial economic impact on the
property.
I declare under penalties of perjury that this complaint (including any attachments) has been examined by me and to the best of my
knowledge and belief is true, correct and complete.
Date ____________ Complainant or Agent ____________________________________ Title (If Agent) __________________________
Signature
Sworn to and signed in my presence, this _____________________________ day of ______________________________ year _________
____________________________________________
Notary Public
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