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NOTICE OF ASSESSMENT
FORM 113
BY ASSESSING OFFICIAL
State Form 46725 (R4 / 12-09)
Prescribed by the Department of Local Government Finance
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Name of taxpayer
Street address (number and street)
City or town
State
ZIP code
You are hereby notified that the assessment as of March 1, 20___________, of the property described below in
_________________________________________ Township, __________________________________________
County, has been changed from $ _______________________________ to $ ______________________________.
Description of property
Notice to the taxpayer of the Opportunity to Appeal (IC 6-1.1-15-1):
If a taxpayer does not agree with the action of the assessing official giving this notice, the County Property Tax Assessment
Board of Appeals will review that action if you file a notice in writing with the Township Assessor (if any) or the County
Assessor within forty-five (45) days of the mailing of this notice. This written notice should include the name of the taxpayer,
the address of the property, the key number or the parcel number of the property, the address of the taxpayer (if different
from the property address), and the telephone number of the taxpayer. An appeal of this assessed value requires evidence
relevant to the value of the taxpayers property as of the assessment date.
DATED: ________ day of _________________________________, 20_______.
Signature of assessing official
Title of assessing official
Typed or printed name of assessing official
Address of assessing official (number and street, city, state, and ZIP code)
To County Auditor:
The reasons for and facts supporting the above action are as follows:
Signature of assessing official
Date signed (month, day, year)