Clear Form
Board of Property Tax Appeals
For Offi cial Use Only
Petition Number and Date Received
2006–2007 PERSONAL PROPERTY PETITION
for
County
•
Read all instructions carefully before completing this form.
•
Please print
or
type
the requested information on both sides of this petition.
• Complete
one petition
form for
each account
you are appealing.
• Return your completed petition(s) to the address shown on the back.
•
Please attach a copy of your tax statement.
• If you wish to appeal the value of a manufactured structure, use the Real Property Petition (150-310-063) instead of this petition.
Petitioner
(Person in whose name petition is fi led)
Owner
1 Check the box that applies:
Person or business, other than owner, obligated to pay taxes (attach proof of obligation)
2 Name—individual, corporation, or other business
3 Telephone number
(
)
(
)
Daytime
Evening
4 Mailing address (street or PO Box)
5 City
6 State
7 ZIP code
}
8 Name of person acting for corporation, LLC, or other business
9 Title (i.e., president, vice president, tax manager, etc.)
FOR
BUSI NESS
USE ONLY
If a representative is named on line 10, all correspondence regarding this petition will be mailed or delivered to the representative.
}
To be completed when petition is signed by an authorized representative of petitioner. Only certain
Representative
people qualify to act as an authorized representative. See the instructions for a list of who qualifi es.
10 Name of representative
11 Telephone number
(
)
(
)
Daytime
Evening
12 Mailing address (street or PO Box)
13 City
14 State
15 ZIP code
16 Relationship to petitioner named on line 2
17 Oregon state bar number
18 Oregon appraiser license number
19 Oregon broker license number
20 Oregon CPA or PA permit or S.E.A. number
Any refund resulting from this appeal will be made payable to the petitioner named on line 2 unless separate written authorization is
made to the county tax collector.
Attendance at Hear ing
Check this box
if you do not
wish to be present or be represented at the hearing. If you choose to not be present at the hearing, the
21
board will make a decision based on the written evidence you submit.
Property Information
22 Assessor’s account number (from your tax statement)
23 Code area number (from your tax statement)
25 Property type
24 Street address and city where property is located
Retail
Industrial
Floating Prop er ty
Offi ce
Motel/Apart ment
Small Man u fac tur ing
Food Ser vice
Other
150-310-064 (Rev. 9-06)
Please turn over—form continues on back