PETITION FOR ABATEMENT OR REFUND OF TAXES
County:____________________
Date Received_____________________
(
Use Assessor’s or Commissioners’ Date Stamp)
Section I: Petitioner, please complete Section I only.
Date: __________________________
Month
Day
Year
Petitioner’s Name:
Petitioner’s Mailing Address:
City or Town
State
Zip Code
SCHEDULE OR PARCEL NUMBER(S)
PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY
_____________________________
_____________________________
_____________________________
Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the
above property for the property tax year ___________ are incorrect for the following reasons: (Briefly describe why
the taxes have been levied erroneously or illegally, whether due to erroneous valuation, irregularity in levying,
clerical error, or overvaluation. Attach additional sheets if necessary.)
Petitioner’s estimate of value:
$________________ (_______)
Value
Year
I declare, under penalty of perjury in the second degree, that this petition, together with any accompanying exhibits
or statements, has been prepared or examined by me, and to the best of my knowledge, information, and belief, is
true, correct, and complete.
_________________________________________
Daytime Phone Number (
)
Petitioner’s Signature
By_______________________________________
Daytime Phone Number (
)
Agent’s Signature*
*Letter of agency must be attached when petition is submitted by an agent.
If the Board of County Commissioners, pursuant to § 39-10-114(1), C.R.S., or the Property Tax Administrator, pursuant to § 39-2-116, C.R.S.,
denies the petition for refund or abatement of taxes in whole or in part, the Petitioner may appeal to the Board of Assessment Appeals pursuant
to the provisions of § 39-2-125, C.R.S., within thirty days of the entry of any such decision, § 39-10-114.5(1), C.R.S.
Assessor’s Recommendation
Section II:
(For Assessor’s Use Only)
Tax Year __________
Actual
Assessed
Tax
Original
________________ ________________ ______________
Corrected
________________ ________________ ______________
Abate/Refund
Assessor recommends approval as outlined above.
If the request for abatement is based upon the grounds of overvaluation, no abatement or refund of taxes shall be made if an objection or protest
to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer, § 39-10-114(1)(a)(I)(D), C.R.S.
Tax year: ________ Protest?
No
Yes (If a protest was filed, please attach a copy of the NOD.)
Assessor recommends denial for the following reason(s):
Assessor’s or Deputy Assessor’s Signature
15-DPT-AR No. 920-66/11