Form Dor 82130aa - Agency Authorization Form

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FOR VALUATION YEAR ________

AGENCY AUTHORIZATION FORM

Pursuant to A.R.S. § 42-16001

STATE BOARD OF APPRAISAL REGISTRATION NUMBER __________

STATE BOARD OF EQUALIZATION NUMBER __________

•

Persons who own, control, or possess property valued by the County Assessor may each year designate an agent to act on their behalf on any matter

relating to the review of the valuation and classification of the property before the Assessor or the County or State Board of Equalization.

•

This designation of an agent expires at the end of the calendar / valuation year.

•

This form or a copy must accompany any petition, Taxpayer Notice of Claim, or response to a Notice of Proposed Correction filed with the Assessor or

either Board of Equalization. The original form shall be provided for inspection by the agent on request of the County Assessor, either Board of

Equalization, or the Department of Revenue.

•

Notices issued by the Assessor or either Board of Equalization relating to the review of the valuation of that property shall be sent to the agent of record.

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A petition for Review of Real Property or Personal Property , a Notice of Proposed Correction, or a Taxpayer Notice of Claim will not be accepted unless the

Agency Authorization form accompanying the petition is signed by the person who owns, controls, or possesses the property.

DESIGNATION OF AGENT: (Type or Print)

AGENT / FIRM NAME

CONTACT PERSON

TELEPHONE

MAILING ADDRESS

CITY, STATE, ZIP

EMAIL ADDRESS

DESIGNATION MADE BY: (Type or Print)

COMPANY NAME

NAME OF PERSON OWNING, CONTROLLING OR POSSESSING PROPERTY OR CONTACT PERSON

TITLE

ADDRESS

CITY, STATE, ZIP

TELEPHONE

EMAIL ADDRESS

I, the undersigned, hereby designate the above name agent to act on my behalf in all matters pertaining to the review and appeal of real or personal

property valuation and classification with the Assessor or the Boards of Equalization. This authorization is limited to the properties listed below and on the

attached continuation form(s).

SIGNATURE OF PERSON CONTROLLING OR POSSESSING PROPERTY

DATE

_____________________________________________________________

_____________________________________________

PRINT NAME (IF DIFFERENT THAN DESIGNATED ABOVE)

PRINT TITLE

PERSONAL PROPERTY

COUNTY

BOOK-MAP-PARCEL

COUNTY

BOOK-MAP-PARCEL