Form Rp-7141 - Complaint On Tentative Special Franchise Full Values
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4RP-7141 (3/11)
New York State Department of Taxation and Finance
Office of Real Property Tax Services
Complaint on Tentative Special Franchise Full Values
for the year _________
DO NOT WRITE IN THIS SPACE
FOR ORPTS USE ONLY
All relevant parts of the complaint form must be completed. Submit any
Complaint Number
Hearing Date
additional documentation which supports your complaint. Serve an original
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 Full Value (Attach additional sheets, if needed.)
ORPTS Tentative
Company’s Estimate
County Name(s)
Assessing Unit(s)
Full Value
of Full Value
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 Full Value (Attach additional sheets, if needed.)
Assessing Unit’s
Company Name(s)
ORPTS Tentative Full Value
Estimate of Full Value
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