Form 132 - Petition To The Indiana Board Of Tax Review For Review Of Exemption Page 3

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SECTION V: CERTIFICATE OF SERVICE
I affirm under the penalties of perjury that a copy of this petition has been served on the following via First Class United States Mail, postage,
prepaid, this ____________ day of ________________, 20_____.
If this petition is filed by the county assessor
County Assessor:
Taxpayer:
Signature
FORM 132 CHECKLIST
I have attached the Notice of Action on Exemption Application (State Form 49585 / Form 120).
I have attached a copy of the Application for Exemption (State Form 9284 / Form 136) filed with the County.
I have checked the type of property under appeal (real, personal, or both) on page 1.
I have identified any other pending exemption appeals for this parcel, on page 1.
If there are other related parcels currently under exemption appeal, a listing of these parcels has been attached.
I have explained in detail the basis for my belief the determination of the county property tax assessment board of appeals
was incorrect (Section III).
I have completed Section I, Section II, Section III, Section IV, and Section V of this petition.
I have signed this petition (Section IV).
I have served a copy of this petition on the other party (Section V).
Information regarding appeal procedures and hearing practice is available on the IBTR website located at
Form 132, page 3

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