______________________________
B
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E
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A
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T
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________________________________
_________________________________,
STIPULATION & ORDER OF APPROVAL
P
t e
i t i
n o
, r e
A
p
e p
l a
N
. o
_ _
_ _
_ _
_ _
_ _
_ _
_ _
_ _
_ _
. v
a P
c r
l e
No(s).
_____________________________
BOARD OF EQUALIZATION OF
_____________________________
___________________ COUNTY,
STATE OF UTAH, ex rel ____________
T
x a
T
p y
: e
r P
p o
r e
y t
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a
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y l
A
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d e
__________________________________
T
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a e
: r
_ _
_ _
_ _
_ _
_ _
_ _
Respondent.
________________________________
STATEMENT OF CASE
This matter is before the Utah State Tax Commission as an appeal from the decision of the County
Board of Equalization pursuant to Utah Code Sec. 59-2-1006. However, the parties have reached an
agreement in this matter and the property owner and county representative(s) hereby stipulate to the market
value(s) as listed below.
Prior Market Value
Stipulated Market Value
Primary
Secondary
Primary
Secondary
Land
$____________
$____________
$____________
$_____________
Buildings/
Improvements
$____________
$____________
$____________
$_____________
TOTAL
$
$
$
$_____________
Greenbelt
$____________
$____________
$_____________
$_____________
We hereby agree that the above-captioned appeal be resolved based on this stipulation for the 20_____
assessment year and waive our rights to any further administrative hearings or appeal process in this matter.
________________________________________
________________________________________
Petitioner
Date
Petitioner
Date
________________________________________
________________________________________
Respondent
Date
Respondent
Date
_________________________________________
_________________________________________
ex rel Party
Date
ex rel Party
Date
TC-104B Rev. 9/13
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