$33/,&$7,21)253523(57<7$;5()81'rris County Tax Assessor-Collector
Post Office Box 4520 Houston, Texas 77210-4520
$33/,&$7,21)253523(57<7$;5()81'
32%R[+RXVWRQ7H[DV3KRQH)D[
Step 1. Identify Account number (7 or 13 digits)
yourself and
the property.
Refund requested by:
Name
Address
This Application City, State, Zip
must be complete and Daytime phone #: Email address:
must be signed by the Description of the property (legal or street address)
taxpayer to be valid.
Step 2. Who Please check one of the following:
normally pays your My mortgage company withholds taxes from my monthly payment.
property taxes? I pay my property taxes directly.
If you bought or sold this property during the tax year, please complete below:
This information is I bought this property during the tax year.
MONTH/YEAR
needed to assure your I sold this property during or after the tax year.
refund is made to the
PLEASE INDICATE NAME OF YOUR MORTGAGE AND/OR TITLE COMPANY
proper party.
Step 3. Provide Please check one of the following and state reason:
the reason for Overpaid the account (explain: )
this refund. HCAD exemption or value reduction granted (date of change: / / )
Paid incorrect account (explain: )
Step 4. Provide
payment
information.
Attach copies Total amount paid by mortgage company or others
of cancelled checks TOTAL AMOUNT PAID (sum of the above amounts)
for all payments you TOTAL PROPERTY TAX OWED
made on this account. AMOUNT PAID MINUS AMOUNT OWED
Step 5. How do you Please check one of the following:
want the refund Mail refund to above mailing address (Step 1)
handled? Transfer this payment to account #__________________________tax year ____________
Reapply this overpayment to several accounts (Please attach a list of accounts)
Step 6. By signing below, I hereby apply for the refund of the above-described taxes and certify that the
Sign the form. information I have given on this form is true and correct. I understand that any person who makes a
false entry upon this record shall be subject to fines and/or imprisonment.
Unsigned applications
SIGNATURE OF TAXPAYER (REQUIRED) DATE
cannot be processed.
AC-501 (1/29/2003)
Payment made by
Tax year
Amount paidDate paidCheck No.
