Application For Partial Tax Exemption - City Of Richmond Page 3

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12. The value determination(s) made by the City Assessor shall be final unless appealed
within 30 days of such notification letter. The applicant may appeal by submitting a
a supported appraisal. Appraisals are subject to professional review.
_______
13. I acknowledge that I have received a copy of the city ordinance and that I am
Responsible for requesting a written response to any question that I may have
regarding proper execution of the ordinance requirements.
_______
14. I have read these Program Guidelines and asked for clarification on any questions
I do not understand.
_______
----------------------------------------------------------------------------------------------------------------------------------------------- -------------
Certification of Application
I certify that the statements contained in this application are both true and correct; that I have read and
understood the guidelines of this program, and received written responses to any questions I may have
regarding this ordinance.
Given under my hand this ____ day of _______________, _______
(Month)
(Year)
 Owner  Agent
_____________________________________________________
(signature)
___________________________________________________
(printed name)
----------------------------------------------------------------------------------------------------- -------------------------------------------------------
Contact Information:
Mailing Address: _________________________________________________________________
Tele #: Day: ____________ Evening: ____________ Email Address: ____________________________
----------------------------------------------------------------------------------------------------------------------------- -------------------------------
OFFICE USE ONLY:
Fee paid $ __________ Receipt Number __________ Qualifying Building Permit # ______________
Date this application and permit application received:
_________/ _________/ ___________
----------------------------------------------------------------------------------------------------------------------------- -------------------------------
Revised: 4/27/2015
900 E. Broad Street, Room 802 Richmond, VA 23219 Ph: 804.646.7500 Fax: 804.646.5686
Email:
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