Form Fp-414 A - Combination Of Lots Request Application printable pdf download

Form Fp-414 A - Combination Of Lots Request Application

Government of the District of Columbia

Office of Tax and Revenue

Real Property Tax Administration

Maps & Title Section

1101 4th Street, S.W., Suite 5011

Washington, D.C. 20024

Combination of Lots Request Application

Please list all lots to be combined:

Square: ________ Suffix: ________ Lot(s): __________

Please list all recorded owners:

______________________________________ _______________________________________

Name

___________________________________ ___________________________________

Name

___________________________________ ___________________________________

Name

Please review and sign:

I/We are the recorded owner(s) or authorized agent for the owners of the above listed lots. I/We

ask that the above lots be combined into one lot for assessment and taxation purposes. These

respective lots are adjacent and owned by the same person(s), organization, and/or

corporation. All property taxes have been paid and updated through September 30th of the current

tax y ear. All combination of lot requests w ill be effective as of t he first hal f of the tax year

beginning October 1.

__________________________

Print Name

Signature

__________________________

Print Name

Signature of Authorized Agent

__________________________

Tax Bill Mailing Address

City, State, Zip Code

__________________________

Date

Telephone Number

FP-414 A (2010)

Form Fp-414 A - Combination Of Lots Request Application