OWNER'S
NAME
LAST FIRST MI
YEAR
Body Damage Is the item inoperative or junked? Yes No
Mechanical Problems Yes No
MODEL
MAKE
DESCRIPTION
OF ITEM
Email Address
Return the form and all supporting documentation to the Commissioner of the Revenue, Attn: Personal Property
Appeals, 755 Roanoke St, Suite 1A, Christiansburg, VA 24073
Commissioner of the Revenue
755 Roanoke St. Suite 1A
Christiansburg, VA 24073
www.montva.com
OFFICE OF
HELEN P. ROYAL, MCR
Master Commissioner
APPEAL OF PERSONAL PROPERTY ASSESSMENT
LICENSE
PLATE #
ODOMETER READING AS OF JANUARY 1 OF TAX YEAR
RECEIVED DATE
FOR OFFICE USE ONLY
DAYTIME PHONE #
FEDERAL ID OR SS#
INSTRUCTIONS
Please review the form carefully and answer all questions. The condition of the item must be below average and
must not be due to average wear and tear on the item. If the condition of the item is not restored, then an appeal
form must be filed each year with the Commissioner of the Revenue by May 1st.
ACCOUNT #
The information may be faxed to (540) 381-6838, emailed to royalhp@montgomerycountyva.gov, or returned in
person to the Commissioner's Office.
If the appeal form is filed within 10 days of the bill due date the entire bill should be paid to avoid penalty and
interest. Any adjustments made will result in a refund or credit on another bill.
REASON FOR APPEAL
Briefly describe the condition of the item and the reasons for appealing the current assessment. Attach all necessary
documentation detailing the condition of the vehicle, repair estimates and photographs. Attach additional sheets if
necessary. The appeal will be denied if supporting documentation is not included with the appeal form.
Is the item still titled at DMV or Game and
Inland Fisheries?
I certify that the above statements of fact are true to the best of my
knowledge.
SIGNATURE
OWNER CERTIFICATION
Phone: 540-382-5710
Fax: 540-381-6838
DATE
Less Appeal Adjustment
Reassessed Value
Authorized By
FOR OFFICE USE ONLY
Email: royalhp@montgomerycountyva.gov
Original Assessment
2020