Petition For Review Of Market Classified Use Value (Page 3 of 4) in pdf

SIGNATURE AND CERTIFICATION SECTION

Under penalties of perjury, I declare that I have read the foregoing petition and that the facts stated in it are true. If I am signing and filing this petition

as an agent of the taxpayer/owner, I further certify that I am duly authorized to do so and agree to act as the taxpayer/owner’s agent for service of

process under F.S. 194.011 (3)(g).

_____________________________________

______________________________________

___________________________

Signature, Taxpayer

Print Name

Date

_____________________________________

______________________________________

___________________________

Signature, Agent

Professional license number or FBN

Date

A petition filed by an unlicensed agent must be signed by the taxpayer or include written authorization from the taxpayer.

Clerk’s Certification: A cashier’s receipt for the required filing fee will be issued to the taxpayer/petitioner by the Clerk of VAB at the time of the

filing of this petition, which shall constitute evidence of such filing for all purposes. (Note: The canceled check shall also be proof of payment in lieu

of cashier’s receipt.) Said receipt shall also constitute the Clerk’s certification that a copy of this petition will be furnished to the Property Appraiser.

Your petition will not be complete until you pay the required filing fee. When the VAB has reviewed and accepted the petition, it will be assigned an

Agenda number for purposes of identification to be used throughout the appeal process.

EMPLOYEE, ATTORNEY, OR LICENSED PROFESSIONAL SIGNATURE

Complete Part 4 if you are the taxpayer’s or an affiliated entity’s employee or you are one of the following licensed representatives. If you are a

registered agent in Miami-Dade VAB, there is no need to complete other than signature section and agent number.

I am (check any box that applies):

 An employee of _______________________________________(taxpayer or an affiliated entity.)

 A Florida Bar licensed attorney (Florida Bar number ________________).

 A Florida real estate appraiser licensed under Chapter 475, Florida Statutes (license number __________________________).

 A Florida real estate broker licensed under Chapter 475, Florida Statutes (license number ___________________________).

 A Florida certified public accountant licensed under Chapter 473 Florida Statutes (license number _______________________).

I understand that the written authorization from the taxpayer is required for access to confidential information from the property appraiser or tax

collector. Under penalties of perjury, I certify that I have authorization to file this petition on the taxpayer’s behalf, and I declare that I am the

owner’s authorized agent for purposes of filing this petition and of becoming an agent for service of process under s.194.011(3)(h), Florida Statutes,

and that I have read this petition and the facts stated in it are true.

____________________________________

__________________________

Signature, Agent

Print Name

Date

UNLICENSED REPRESENTATIVE SIGNATURE

Complete part 5 if you are an authorized representative not listed in part 4 above.

 I am a compensated representative not acting as one of the licensed representatives or employees listed in part 4 above AND (check one)

 Attached is a power of attorney that conforms to the requirements of Part II of chapter 709, F.S., executed with the taxpayer’s authorized signature

OR  the taxpayer’s authorized signature is in part 3 of this form.

 I am an uncompensated representative filing this petition AND (check one)  the taxpayer’s authorization is attached OR  the taxpayer’s

authorized signature is in part 3 of this form.

I understand that written authorization from the taxpayer is required for access to confidential information from the property appraiser or tax

collector.

Under penalties of perjury, I declare that I am the owner’s authorized agent for purposes of filing this petition and of becoming an agent for service

of process under s. 194.011(3)(h), Florida Statutes, and that I have read this petition and the facts stated in it are true.

___________________________________

__________________________

Signature, Agent

Print Name

Date

CLK/CT 481 Rev. 08/16 (MD-486MC)

Clerk’s web address: Page 3