AGENCY AUTHORIZATION FORM
FOR VALUATION YEAR ________
Pursuant to A.R.S. § 42-16001
STATE BOARD OF APPRAISAL REGISTRATION NUMBER __________
STATE BOARD OF EQUALIZATION NUMBER __________
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Persons who own, control, or possess property valued by the County Assessor may each year designate an agent to act on their behalf on any matter
relating to the review of the valuation of the property before the Assessor or the County or State Board of Equalization.
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This designation of an agent expires at the end of the calendar / valuation year.
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This form or a copy must accompany any petition, Taxpayer Notice of Claim, or response to a Notice of Proposed Correction fi led with the Assessor or
either Board of Equalization. The original form shall be provided for inspection by the agent on request of the County Assessor, either Board of
Equalization, or the Department of Revenue.
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Notices issued by the Assessor or either Board of Equalization relating to the review of the valuation of that property shall be sent to the agent of record.
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A petition for Review of Real Property or Personal Property, a Notice of Proposed Correction, or a Taxpayer Notice of Claim will not be accepted unless the
Agency Authorization for accompanying the petition is signed by the person who owns, controls, or possesses the property.
DESIGNATION OF AGENT: (Type or Print)
AGENT / FIRM NAME
CONTACT PERSON
TELEPHONE
MAILING ADDRESS
CITY
STATE
ZIP
DESIGNATION MADE BY: (Type or Print)
COMPANY NAME
NAME OF PERSON OWNING, CONTROLLING OR POSSESSING PROPERTY OR CONTACT PERSON
TITLE
ADDRESS
CITY
STATE
ZIP
TELEPHONE
I, the undersigned, hereby designate the above name agent to act on my behalf in all matters pertaining to the review and appeal of real or personal
property valuation and classifi cation with the Assessor or the Boards of Equalization. This authorization is limited to the properties listed below and on the
attached continuation form(s).
Signature of Person Owning, Controlling or Possessing Property
Date
PERSONAL PROPERTY
COUNTY
BOOK-MAP-PARCEL
COUNTY
BOOK-MAP-PARCEL
COUNTY
BOOK-MAP-PARCEL
ASSESSMENT ACCOUNT
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County Name and Number: (1) Apache
(2) Cochise
(3) Coconino
(4) Gila
(5) Graham
(6) Greenlee
(7) Maricopa
(8) Mohave
(9) Navajo
(10) Pima
(11) Pinal
(12) Santa Cruz
(13) Yavapai
(14) Yuma
(15) La Paz
NOTE: USE CONTINUATION FORM DOR 82130AAA TO LIST ADDITIONAL PARCELS
DOR 82130AA (3/04)
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