Certification For Loss In Assessed Value Of Vacant Land Attributable To Revaluation {HWP-1A}

P.L. 2004, CHAPTER 120 HIGHLANDS WATER PROTECTION ACT CERTIFICATION FOR LOSS IN ASSESSED VALUE OF VACANT LAND ATTRIBUTABLE TO REVALUATION, REASSESSMENTS AND TAX APPEALS FOR THE TAX YEAR 20__. COUNTY MUNICIPALITY 1 BLOCK 2 LOT 3 QUALIFIER 4 2003 BASE YEAR LAND ASSESSMENT 5 CURRENT YEAR LAND ASSESSMENT 6 LOSS IN ASSESSED VALUE (col 4 - col 5) 7 REASSESSMENT, REVALUATION, COMPLIANCE PLAN 8 TAX APPEAL MUNICIPAL TOTALS I, ________________________ , ASSESSOR OF____________________ DO SWEAR (OR AFFIRM) THAT THE FOREGOING LIST CONTAINS A TRUE AND COMPLETE RECORD OF PROPERTIES WHERE THE ASSESSMENT FOR THE CURRENT YEAR HAS BEEN REDUCE DUE TO A CHANGE IN ASSESSED VALUE ATTRIBUTABLE TO THE APPLICATION OF P.L.. 2004, CHAPTER 120. THIS LIST TO THE BEST OF MY ABILITY, REPRESENTS ALL VACANT LAND ELIGIBLE FOR REVENUE REPLACEMENT IN THE TAXING DISTRICT IN WHICH I AM THE ASSESSOR. ASSESSOR SWORN AND SUBSCRIBED BEFORE ME THIS ______DAY OF _________, 20____ FORM HWP1 American LegalNet, Inc. www.FormsWorkflow.com