CASE # ______

APPLICATION FOR REVIEW OF RESIDENTIAL ASSESSMENT

Mail completed applications to:

BOARD OF EQUALIZATION

9540 Center Street, Ste. 303C

MANASSAS, VA 20110

THE DEADLINE FOR FILING 2017 ASSESSMENT APPEALS IS July 3, 2017

NATURE OF GRIEVANCE: ______Assessment is in excess of Fair Market Value

______Assessment is inequitable with comparable properties

______Assessment made on incorrect data

______Assessment not determined in accordance with generally accepted real estate appraisals

______Other reasons (Please explain below)

OWNER’S NAME

PROPERTY ADDRESS

MAILING ADDRESS

(of person to be contacted concerning appeal)

VALUE YOU BELIEVE THE PARCEL WAS WORTH ON JANUARY 1, 2017

Is the property listed for sale? ______If so, at what amount? ______

Was the property listed for sale since 1/1/16? ______If so, at what amount? ______

Is this property insured? ______If so, at what amount? ______

What particular points do you believe the Board of Equalization should consider that might lead to a change in the assessment? Use additional page(s) if necessary.

Please fill in account number and Grid Parcel Identification number (GPIN):

RPC/Account #: __ GPIN/Parcel ID: ______

2017 ASSESSMENT: IF LOWERED BY ASSESSMENTS: 2016 ASSESSMENT:

LAND (MKT) LAND (MKT) LAND (MKT)

LAND (USE) LAND (USE) LAND (USE)

IMP IMP IMP

TOTAL TOTAL TOTAL

Office Use Only:

If there are comparable properties that the applicant believes should be considered, please provide the following information:

A.  Property Address

GPIN Assessment

State differences and/or similarities compared to your property:

B.  Property Address

GPIN Assessment

State differences and/or similarities compared to your property:

C.  Property Address

GPIN Assessment

State differences and/or similarities compared to your property:

Signature of Applicant Print Name

Telephone No. : Home

Work ______

Cell ______

E-mail address ______

Do you want to be notified of the date and time of the hearing, even though it is not necessary for you to be present for the hearing to occur?

( ) YES ( ) NO