Form Center

2. Date/Time
   Date/Time

   Date/Time
4. Record #
5. Tax Map #
7. First Name
8. Last Name
10. Address
12. City
13. State
14. Zip
16. Cell Phone #
17. Home Phone #
18. Email Address
20. Assessed Value
22. Land
24. Building
26. Total
28. Appeal Complaint

    1. Building Square Footage Incorrect
    2. Acreage Incorrect
    3. Previously Unrecognized Condition
    4. Address Update
30. Remarks
32. State your opinion of market value $
36. OFFICE USE ONLY
38. Appeal Made Via

    1. Phone
    2. Email
    3. Personal Interview
    4. Letter
    5. Other
39. Date Received
41. Date Field Visit
42. Date Finalized
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field