Form 113 / Pp - Notice Of Assessment / Change - State Of Indiana
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1NOTICE OF ASSESSMENT / CHANGE
(By An Assessing Official)
ASSESSMENT DATE
FORM 113 / PP
State Form 21521 (R4 / 12-01)
MARCH 1, ________
Prescribed by the Department of Local Government Finance
NOTE: If you do not agree with the action the County Property Tax Assessment Board of Appeals will review that action if you file a petition with the
County Assessor of this county within forty-five (45) days of this notice. IC 6-1.1-15-1.
This form is to be used by an assessing official to notify a taxpayer of an assessment or change in assessment, pursuant
INSTRUCTIONS:
to IC 6-1.1-3 or IC 6-1.1-9.
Name of taxpayer
Address (number and street, city, state, ZIP code)
You are hereby notified that the undersigned assessing official has taken the action described below with regard to the following property:
LOCATION OF PROPERTY
Taxing district
County
Township
Address where property is located (number and street, city, ZIP code)
DESCRIPTION OF PROPERTY
Individual's Personal Property (Form 101 )
Farmer's Personal Property (Form 102 )
Business Personal Property (Form 103 )
ACTION
Assessed value has been changed from $ _________________ to $ _________________ .
Failure to file required assessment return. Assessment has been estimated to be $ ___________________________________ .
Other (explain )
REASON(S) FOR ACTION
Failure to file required assessment return. You have the right to file an assessment return within 30 days of the first notice. (IC 6-1.1-3-15)
Omitted property (describe below)
Mathematical error (describe below)
Mandatory or allowable adjustment not properly computed or disallowed: (describe and state below)
Inventory adjustment not properly computed
Abnormal obsolescence adjustment disallowed [be sure to specify reason(s)]
In-whole
In-part
Exemption disallowed (describe and give reasons):
Interstate commerce exemption (be specific)
Air pollution control equipment not qualified
Industrial waste control equipment not certified by Department of Environmental Management
Other
Description or reasons (attach additional sheet if necessary)
Date of this Notice
Name (print)
Telephone number
Title
Signature
(
)
Address (number and street, city, state, ZIP code)
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