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Application For Changed Assessment 2012-13 - California
| Application For Changed Assessment 2012-13 Form. This is a California form and can be used in Assessment Appeals Board Board Of Supervisors Los Angeles Local County . |
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Please type or print in ink -- SEE INFORMATION AND INSTRUCTIONS PAGE County of Los Angeles Assessment Appeals Board APPLICATION NUMBER REGION 1. APPLICANT'S NAME (Last , First, M.I.) Person to Contact (if other than above) APPLICATION FOR CHANGED ASSESSMENT 2012/13 This form contains all the requests for information that are required for filing an application for changed assessment. Failure to complete this application may result in rejection of the application and/or denial of the appeal. Applicant should be prepared to submit additional information if requested by the Assessor or at the time of the hearing. Failure to provide information the Assessment Appeals Board considers necessary may result in the continuance of the hearing. Street Address/PO Box# (MUST be applicant's mailing address) City Daytime Phone Alternate Phone State Zip Code Fax Number 4. VALUE Land Improvement Fixtures A. Value on Roll B. Applicant's Opinion of Value E-Mail Address Personal Property Mobile Home Mobile Home/Other PM DATE RECEIVED Walk in By 2. AGENT OR ATTORNEY FOR APPLICANT Agency Name Person to Contact (if other than above) 7. WRITTEN FINDINGS OF FACTS (Minimum of $181.00 per parcel) Are Requested Are Not Requested TOTAL Street Address/PO Box# 5. TYPE OF ASSESSMENT BEING APPEALED (Check one only) IMPORTANT-SEE INSTRUCTIONS FOR FILING PERIODS 8. CLAIM FOR REFUND Please refer to instructions first. Do you want to designate this application as a claim for refund? Yes No City Daytime Phone Alternate Phone State Zip Code Fax Number REGULAR ASSESSMENT--Value as of January 1 of current year. SUPPLEMENTAL ASSESSMENT-- Attach a Copy of Notice or Tax Bill. Date of Notice or Tax Bill_________________ Roll Year______________ ROLL CHANGE/ADJUSTED/ESCAPE ASSESSMENTS/CALAMITY REASSESSMENT Attach a Copy of Notice or Tax Bill. Date of Notice or Tax Bill________________ Roll Year______________ 9. HEARING OFFICER PROGRAM If your property is a single-family dwelling, condominium, cooperative or multi-family dwelling of four units or less, regardless of value, or a property that does not exceed $3,000,000 assessed value, you may request that your hearing be conducted by an Assessment Hearing Officer, instead of a formal Assessment Appeals Board. Do you wish to have your appeal heard before an Assessment Appeals Hearing Officer? Yes No E-Mail Address AGENT'S AUTHORIZATION If the Applicant is a corporation, the agent's authorization must be signed by an officer or authorized employee of the business entity. If the agent is not an attorney licensed in California or a spouse, child or parent of the person affected, the following must be completed or a separate authorization may be attached as outlined in the instructions. PRINT NAME OF AGENT AND AGENCY is hereby authorized to act as my agent in this application and may inspect Assessor's records, enter into stipulations, and otherwise settle issues relating to this application. SIGNATURE OF APPLICANT/OFFICER/AUTHORIZED EMPLOYEE 6. THE FACTS that I rely upon to support the requested changes in value are as follows: You may check all that apply. If uncertain of which item to check, please check "I. Other" and attach two copies of a brief explanation of your reason(s) for filing this application. PLEASE SEE INSTRUCTIONS BEFORE COMPLETING THIS SECTION CERTIFICATION I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing and all information hereon, including any accompanying statements or documents, is true, correct, and complete to the best of my knowledge and belief and that I am (1) the owner of the property or the person affected (i.e., a person having a direct economic interest in the payment of the taxes on that property -- "The applicant"), (2) an agent authorized by the applicant under Item 2 of this application, or (3) an attorney licensed to practice law in the State of California, STATE BAR NO.____________________, who has been retained by the applicant and has been authorized by that person to file this application. DATE SIGNATURE (Please use blue ink) PRINT NAME AND TITLE DATE 3. PROPERTY IDENTIFICATION INFORMATION Secured: Assessor's ID No. Map Book Unsecured Tax Bill No. Property Address or Location________________________________________________________________ Economic Unit (attach Form AAB101) PROPERTY TYPE: Single Family Residence/Condo/Townhouse Apartments, Number of Units_________ Vacant Land Agricultural Commercial/Industrial Business Personal Property/Fixtures Other________________________ Yes No Page Parcel A. DECLINE IN VALUE: The Assessor's roll value exceeds the market value as of January 1 of the current year. B. CHANGE OF OWNERSHIP: B1. No change of ownership or reassessable event occurred on the date of ____________. B2. Base year value for the change in ownership established on the date of ____________ is incorrect. C. NEW CONSTRUCTION: C1. No new construction or reassessable event occurred on the date of ____________. C2. Base year value for the new construction established on the date of ____________ is incorrect. D. CALAMITY REASSESSMENT: Assessor's reduced value is incorrect for property damaged by misfortune or calamity. E. PERSONAL PROPERTY/FIXTURES: Assessor's value of personal property and/or fixtures exceeds market value. E1. All personal property/fixtures. E2. Only a portion of the personal property/fixtures. Attach description of those items. F. PENALTY ASSESSMENT: Penalty assessment is not justified. G. CLASSIFICATION: Assessor's classification and/or allocation of value of property is incorrect. H. APPEAL AFTER AN AUDIT: MUST include description of each property, issues being appealed, and your opinion of value. Please refer to instructions. H1. Amount of escape assessment is incorrect. H2. Assessment of other property of the assessee at the location is incorrect. I. OTHER Explain below or attach two copies of explanation. NAME AND TITLE (Please print or type) OWNER SPOUSE AGENT PARENT ATTORNEY CHILD PERSON AFFECTED REGISTERED DOMESTIC PARTNER SIGNED AT : (CITY, STATE) AAB OFFICE USE ONLY DUPLICATE OF: 201______-______________________________ 201______-_____________________________ INVALID: Is this property an owner-occupied, single family dwelling? Form AAB100 (SBE.ASD.PTR305.LACOAAB) REV 04/12 SEE INFORMATION AND INSTRUCTIONS PAGE INFORMATION AND INSTRUCTIONS FOR APPLICATION FOR CHANGED ASSESSMENT 2012/13 The State Board of Equalization has prepared a pamphlet to assist you
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