County Of Los Angeles Ttc - Tax Penalty Cancellation Request
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1
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3COUNTY OF LOS ANGELES
TREASURER AND TAX COLLECTOR
KENNETH HAHN HALL OF ADMINISTRATION
225 NORTH HILL STREET, ROOM 115
POST OFFICE BOX 512102
LOS ANGELES, CALIFORNIA 90051-0102
HOME PAGE
JOSEPH KELLY
TTC.LACOUNTY.GOV
TREASURER AND TAX COLLECTOR
PROPERTY TAX PORTAL
PENALTY CANCELLATION REQUEST
Assessor’s Identification Number (AIN) or Assessor’s Bill Number: _____________
Taxpayer Name: ________________________________________________________
Claimant Name: ________________________________________________________
Mailing Address: _______________________________________________________
Daytime Telephone: (
) _________________ email: _________________________
Please indicate the type of tax bill, year and installment period(s) for which you are requesting a
penalty cancellation. If your request is for more than two tax years, please submit an additional
Penalty Cancellation Request form(s) for the additional tax year(s). Each request must be
signed and dated.
Annual
Supplemental
Prior Years
Unsecured
Adjusted Bill
st
nd
Tax Year _________ Installment
1
2
Penalty Paid $_________
st
nd
Tax Year _________ Installment
1
2
Penalty Paid $_________
Please fully describe the reason(s) for filing this claim. Attach all supporting documentation (if
you require additional space, attach additional sheets to the request):
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
I declare under penalty of perjury that the information contained in this claim is true and correct
and that I am signing as the assessee of record or his/her authorized agent.
Signature: ______________________________________ Date: _____________________
Sign and mail the request, along with all your supporting documentation to the address below:
Treasurer and Tax Collector
County of Los Angeles
Post Office Box 512102
Los Angeles, CA 90051-0102
You may also scan and email this request to penalty@ttc.lacounty.gov.
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