Form Rp-7142 - Complaint On Tentative Special Franchise Assessments

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RP-7142 (3/11)
New York State Department of Taxation and Finance
Office of Real Property Tax Services
Complaint on Tentative Special Franchise Assessments
for the year ______
DO NOT WRITE IN THIS SPACE
DO NOT WRITE IN THIS
All relevant parts of the complaint form must be completed. Submit any
FOR ORPTS USE ONLY
SPACE
additional documentation which supports your complaint. Serve an original
Complaint Number
Complaint
Hearing Date
Hearing
Number
Date
and two copies of this complaint on the Commissioner and one copy on each
adverse party. Service may be made in person or by mail.
PART ONE: GENERAL INFORMATION
1.
Special Franchise Owners: Complete this section.
a. Complainant Information
Company Name
Street Address, City, State, Zip
(
)
(
)
Telephone Number
Fax Number
b. List of Assessing Units and Company’s Estimates of Assessment (Attach additional sheets, if needed.)
ORPTS Tentative
Company’s Estimate
County Name(s)
Assessing Unit(s)
Assessment
of Assessment
2.
Assessing Units: Complete this section.
a. Complainant Information
Assessing Unit Name
Street Address, City, State, Zip
(
)
(
)
Telephone Number
Fax Number
b. List of Companies and Assessing Unit’s Estimates of Assessment (Attach additional sheets, if needed.)
Assessing Unit(s)
Company Name(s)
ORPTS Tentative Assessment
Estimate of Assessment

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