2009 Real Estate Assessment Appeal Application - Virginia Department Of Tax Administration

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2009 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: 703-222-7594;
Español 703-324-3855
Appeal Number: ___________________________
E-mail:
Assigned to Appr: ____ Date Due: ___/___ /_____
Internet:
APPEAL DEADLINE IS APRIL 3rd
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 January 1st:
2009 Assessment Notice Values: Land:
Building:
Total:
P
, under state law neither financial impact nor the rate of value change is by itself sufficient
LEASE NOTE
grounds for appeal. As required, DTA’s assessment is an estimate of fair market value as of
January 1, 2009. We do welcome appeals based on issues such as factual discrepancies or demonstrable
issues of uniformity or fair market value. Please select your appeal basis (you must select at least one):
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. Accurate property characteristic details are listed 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 January 1, 2009 should be:
Land:
Building:
Total:
I hereby certify that the facts contained herein and attached hereto are true,
accurate, and correct, to the best of my knowledge and belief.
If applicant is not the owner of record, application must include
an original Letter of Authorization from the owner, signed prior
Given under my hand this ______ day of __________________, 20___
to date of application, either notarized or on owner’s commercial
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): __________________________________________________
__________________________________________________________________________________________________________
I
I
C
O
:
HECK
NE
AM THE OWNER OF RECORD
AM NOT THE OWNER OF RECORD
CONTINUED ON REVERSE SIDE
Revised 02/17/2009

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