Form 113/pp - Notice Of Assessment Change - State Of Indiana
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1NOTICE OF ASSESSMENT / CHANGE
ASSESSMENT DATE
(By An Assessing Official)
FORM 113 / PP
MARCH 1, 20______
State Form 21521 (R5 / 1-08)
Reset Form
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.
INSTRUCTIONS: This form is to be used by an assessing official to notify a taxpayer of an assessment or change in assessment, pursuant to IC 6-1.1-3 or IC 6-1.1-9.
Name of taxpayer
Address (number and street, city, state, and 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
County
Township
Taxing district
Address where property is located (number and street, city, and 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 before deductions has been changed from $ ________________________ to $ ________________________ .
Assessed value of a deduction was 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)
Mathematical error (describe below)
Omitted property (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)]
Exemption disallowed (describe and give reasons):
In-whole
In-part
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 (month, day, year)
Name (print)
Telephone number
Title
Signature
(
)
Address (number and street, city, state, and ZIP code)
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