Application for Tax Penalty Relief
Revenue & Taxation Code 4985.2(a)
Request for relief from tax delinquency penalties, tax-defaulted property penalties
and/or costs associated with tax delinquencies or defaults must be completed on this
application. Application must be accompanied by payment of taxes, penalties and
applicable costs made payable to the Treasurer-Tax Collector.
Applications that are not accompanied by the payment of taxes,
penalties and applicable costs will be automatically denied.
Name:
Company (if applicable):
Mailing Address:
City: State: Zip:
Daytime Phone Number: Fax Number:
Property Information:
1115 Truxtun Avenue * Bakersfield, California 93301-4639 * (661) 868-3490 * 800-552-KERN
Fax: (661) 868-3409 * Email: ttc@kerncounty.com * www.kcttc.co.kern.ca.us
EMail Address:
Assessor Tax Number(s) (ATN):
Tax Bill Number(s):
File Number:
Owner Of Record:
Property Address:
Other Phone Number:
Requestor Information:
Reason for Application for Tax Penalty Relief:
Signature:
NOTE: Signature must be of the property owner or, if the property owner is a partnership, corporation or a
limited liability company, by an officer or agent of that property owner properly authorized to submit property
tax-related documents on behalf of the property owner. Such authorization must be demonstrated by written
evidence from the property owner and submitted with this signed application.
For Treasurer and Tax Collector Use Only
Payment Submitted:
penwaiverapp.pdf 01/20
(A detailed, written explanation must include all supporting documentation at the time the
application is submitted).
Date:
1115 Truxtun Avenue * Bakersfield, California 93301-4639 * (661) 868-3490 * 800-552-KERN
Fax: (661) 868-3409 * Email: ttc@kerncounty.com * www.kcttc.co.kern.ca.us
Yes
No
Date Approved:
Date Denied:
Date Received:
Reason for Denial: