Form Cvr-1 - Notice Of Referral To The Office Of Dispute Resolution - 2000
ADVERTISEMENT
1MONTANA
Form CVR-1
3-2000
Montana Department of Revenue
Compliance, Valuation & Resolution
NOTICE OF REFERRAL TO THE OFFICE OF DISPUTE RESOLUTION
In compliance with the MCA, you may appeal a decision made by the Department of Revenue based upon the informal review of
your assessment. You must file this Notice of Referral within 30 days of receipt of the Department of Revenue decision of the
informal review of your assessment. Please attach a copy of your Request for Informal Review (Form # AB-26) to this form.
Following my informal review, I hereby make application to the Office of Dispute Resolution of the Department of Revenue for
review on this ________________________ day of ______________________________, 2____________.
Please indicate the type of tax and tax periods you are disput-
E-mail ____________________________________________
ing, (Property, Corporation, Natural Resource, Income, etc.):
__________________________________________________
County of __________________________________________
__________________________________________________
__________________________________________________
Account Number ____________________________________
__________________________________________________
FEIN ______________________________________________
Owner / Company Name and Address:
___________________________________________________
SSN _______________ - _________ - __________________
___________________________________________________
__________________________________________________
Geocode ___________________________________________
__________________________________________________
Assessor’s Code ____________________________________
Person Filing this Form (If different from Above):
__________________________________________________
Legal Description:____________________________________
__________________________________________________
___________________________________________________
__________________________________________________
___________________________________________________
__________________________________________________
___________________________________________________
___________________________________________________
Phone # (____) ______ - __________
Fax #
(____) ______ - __________
I Hearby Authorize _________________________________________________________________(PRINTED name of agent)
to represent me in this matter.
Signature of Customer ____________________________________________________________ Date ___________________
FOR DEPARTMENT USE ONLY
___________________________
______________________
Date Received by CVR
Date Forwarded to ODR
No
Yes; If Yes, Date Reviewed ________________
Was a Request for Informal Review (Form # AB-26) Filed?
Person Receiving this Form ________________________________ Title / Role ______________________________________
4001
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial