Form Dr-486dp - Petition To The Value Adjustment Board Tax Deferral Or Penalties Request For Hearing

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DR-486DP
PETITION TO THE VALUE ADJUSTMENT BOARD
R. 11/12
Rule 12D-16.002
TAX DEFERRAL OR PENALTIES
Florida Administrative Code
Effective 11/12
REQUEST FOR HEARING
COMPLETED BY CLERK OF THE VALUE ADJUSTMENT BOARD (VAB)
Petition #
County
Select County
Tax year 20
Date received
COMPLETED BY THE PETITIONER
PART 1. Taxpayer Information
Taxpayer name
Agent
Mailing
Parcel ID and
address for
physical address
notices
or TPP account #
Phone
Fax
Email
The standard way to receive information is by US mail. If possible, I prefer
email
fax.
I will not attend the hearing but would like my evidence considered. You must submit duplicate copies of
your evidence to the value adjustment board clerk. Florida law allows the tax collector to cross examine or
object to your evidence. The ruling will occur under the same statutory guidelines as if you were present.
PART 2. Type of Deferral or Penalty Appeal
Disapproval of homestead tax deferral
Disapproval of affordable rental tax deferral
Disapproval of recreational and commercial working waterfront tax deferral
Penalties imposed under section 197.301, F.S., homestead, affordable rental housing property, or
recreational and commercial working waterfront
You must submit a copy of the original application for tax deferral filed with the tax collector and related documents.
Enter the time (in minutes) you will need to present your case. Most hearings take 15 minutes. The VAB is not
bound by the requested time. For single joint petitions for multiple parcels, enter the time needed for the entire group.
There are specific dates my witnesses or I will not be available to attend. I have attached a list of dates.
At the hearing, you have the right to have witnesses sworn.
PART 3. Certification
Under penalties of perjury, I declare that I am the owner of the property described in this petition or the authorized
agent of the owner for purposes of filing this petition and for purposes of becoming agent for service of process under
s. 194.011(3)(g), Florida Statutes, and that I have read this petition and the facts stated in it are true.
Signature, taxpayer
Print name
Date
Signature, agent
Professional license number or FBN
A petition filed by an unlicensed agent must be signed by the taxpayer or include written authorization from the taxpayer.
I am filing this petition after the petition deadline. I have attached a statement of the reasons I filed late and any
documents that support my statement.
Your petition will not be complete until you pay the filing fee. When the VAB has reviewed and accepted it, they will assign
a number, send you a confirmation, and give a copy to the tax collector.

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