Harris County Appraisal District
P.O. Box 922004
Houston, TX 77292-2004
Fax # (713)957-7864
AGTREM (05/06)
Removal of Agent
Instructions: The appraisal district will remove an agent authorization upon written request by the property owner
Step 1:
Owner's
Name and
Address
Owner's Name:
Current Mailing Address(number and Street):
City, State, ZIP code:
Step 2:
Agent
to be
Removed
Agent Code:Agent's Name:
Property Address:Account Number:
Property Address:Account Number:
Property Address:Account Number:
Property Address:Account Number:
Property Address:Account Number:
Property Address:Account Number:
Step 3:
Properties
to which
this
Removal
Applies
Step 4:
Comments
The Agent listed above is no longer authorized to represent me on these properties
Printed Name
Signature:
Step 5:
Sign and
Date
Date