Application To The Board Of Assessment Appeals - Town Of Brookfield
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1Application to the Board of Assessment Appeals
Town of Brookfield
100 Pocono Rd. Brookfield, CT 06804
Room #129
Motor Vehicles on the October 1, 2015 Grand List
Thursday, September 22, 2016 6:00 pm
Saturday, September 24, 2016 8:30 am
No appointment necessary
Filing an appeal does not affect the tax bill due date; interest and penalties will be applied to late payments.
You must bring this form (one completed form for each vehicle) and a copy of your most recent tax bill to
the hearing. An odometer statement as of October 1, 2015 from a mechanic/garage is required if the appeal
is based on mileage.
To be completed by Owner:
Board of Assessment Appeals use only:
Name:_____________________________________
Your appeal is:
Granted
Denied
Old Assessment
New Assessment
Address:___________________________________
Motor Vehicle ______________ _______________
____________________________________
___________________________________________
Brian Lerner
Motor Vehicle:
Model ______________________________
___________________________________________
Stanley Parker
Year __________ Make________________
___________________________________________
Owner’s Estimate of Value:_____________________
Vacant
Reason for Appeal:___________________________
Date:_______________________________________
__________________________________________
Appeals from the action of the BAA are filed with the
Danbury Superior Court within two (2) months of this
Signature:__________________________________
Board’s Action.
Date:______________________________________
If you cannot be available on September 22
24, 2016 and will assign an Agent to represent you at the
or
hearing, the following MUST be completed and available to the board members on September 22
24, 2016.
or
I ______________________________________ being the registered owner of the motor vehicle listed
above hereby authorize_______________________________________ (PLEASE PRINT) to act as
my agent for the motor vehicle hearing before the Board of Assessment Appeals for the Town of
Brookfield as of the assessment year commencing October 1, 2015.
Signed:_____________________________________
Date:_________________________________
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