Fillable Form Tc-739 - Petition For Expedited Hearing printable pdf download

Form Tc-739 - Petition For Expedited Hearing

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Before the Utah State Tax Commission

Petition for Expedited Hearing

PETITIONER:

PETITIONER=S REPRESENTATIVE (if any):

Name: ________________________________________

Name:___________________________________________

Daytime Phone: ________________________________

Daytime Phone: ___________________________________

FAX: ________________________________________

FAX: ___________________________________________

Mailing Address _______________________________

Mailing Address: __________________________________

_____________________________________________

________________________________________________

I authorize the above-named person to discuss this

Appeal with the Utah State Tax Commission.

Yes

PRIMARY ISSUE:

This appeal involves an assessment, decision, or action by:

Property Tax Division

Taxpayer Services Division

Motor Vehicle Enforcement Division

Auditing Division

Motor Vehicle Division

Other _____________________________________

Certified Tax Rate

Describe the primary issue:

Factor Order

Other (Explain)

Reason for requesting expedited hearing:

If this appeal results from a decision, letter, assessment, or notice issued by a Division of the Tax Commission, state the date of that action

and the name and title of the person who took the action. (Attach a copy of any letter or notice to this form.)

_____ / _____ / _____ ________________________________________________________________________________________

Date

Name and Title

Section 59-1-501.5 of the Utah Code entitles the petitioning party to an Initial Hearing, with rights to pursue the matter further in a

Formal Hearing. As the petitioning party, you may waive your right to the Initial Hearing and proceed directly to the Formal

Hearing. Indicate your preference:

I waive the Initial Hearing

I request an Initial Hearing

REQUEST FOR RELIEF:

Describe the basis for your appeal and the relief that you seek from the Tax Commission (attach additional pages if necessary):

Signed: __________________________________________________

Date: ____________________________________________

The Tax Commission Appeals Unit will accept all written submissions by email, mail, or fax:

Utah State Tax Commission

Appeals Unit

210 North 1950 West

SLC, UT 84134

Fax: 801-297-3919

Email: taxappeals@utah.gov

TC-739 Rev. 5/13

Form Tc-739 - Petition For Expedited Hearing

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