Please Type or Print Clearly
A complaint is hereby made to have the following property removed from the tax-exempt list and placed on the taxable
list for the year in which the complaint is led.
Name (if different from complainant)
City State ZIP code Telephone number
Complaint Against the Continued Exemption
of Real Property from Taxation
Prescribed 4/05
County name
Of ce Use Only
County complaint number
DTE complaint number
Date received by DTEDate received by county auditor
General Instructions
Submit three copies of this application to the auditor’s of ce in the county where the property is located. (Make a copy for
your records.) The nal deadline for ling with the county auditor is Dec. 31 of the year for which exemption is challenged.
If you need assistance in completing this form, contact your county auditor.
This complaint may be led by any person, board, or of cer authorized by Ohio Revised Code (R.C.) 5715.19 to le with a
county board of revision against any real property granted tax exemption by tax commissioner under R.C. 5715.27. Eligible
complainants are the following: any person owning taxable real property in the county or in a taxing district with territory in
the county, the board of county commissioners, the prosecuting attorney or treasurer of the county, the board of township
trustees of any township with territory in the county, the board of education of any school district with any territory in the
county, or the mayor or legislative authority of any municipal corporation with any territory in the county.
Answer all questions on the form. If you need more room for any question, use additional sheets of paper to explain details.
Please indicate which question each additional sheet is answering. Obtain a copy of the property record card from the
county auditor and enclose it with this complaint.
Complainant name
Notices concerning
this application
should be sent to
1. Parcel number(s).(If more than four,
continue on an attached sheet.)
All parcels must be in the same
school district.
2. School district where located
3. Total size of parcel(s) Less than one acre One acre or more Number of acres
4. Street address or location of property
5. a. Title to this property is in the name of
b. Address of owner
CANTON, OH 44702
TELEPHONE: (330) 451-7184
Prescribed 4/05
Page 2
6. If known, title holder is (check one) A nonpro t corporation An unincorporated association/organization
An individual Other
7.State your reasons why you believe this property no longer quali es for exemption. Be speci c about what is being done
on the property and who uses it, or that the property is not currently being used at all. For example, state whether the
property is leased or rented to anyone, used for the operation of any business, used for agricultural purposes, used to
produce any income other than donations, or has anyone living or residing on any part of this property. Attach any avail-
able documentation that supports your complaint.
The Ohio Department of Taxation may set a hearing on this application. If there is a hearing, the applicant must
present a witness who can accurately describe the use of the property in question. A notice of at least 10 days will
be given to the complainant concerning the time and place of any hearing.
I declare under penalty of perjury that I have examined this application and, to the best of my knowledge and belief, it is
true, correct and complete.
Complainant or representative
Print name and title
City State ZIP code
Telephone number Date
County Auditors Finding
1. If, after reviewing the complaint form, the county auditor believes that any or all of the property subject to the com-
plaint is no longer eligible for exemption, the auditor may restore it to the taxable list under R.C. 5713.08. If the auditor
does restore the property to the taxable list, the auditor must follow the procedures under R.C. 5713.082 by sending
a notice to the property owner by certi ed mail that the property is now subject to taxation. That notice must describe
the property and indicate that the owner may reapply for tax exemption by ling DTE form 23 or DTE form 24, as ap-
propriate. Such notice must also contain a statement that failure to le that exemption application within the proper
time period will result in the owner having to pay the taxes, even if the property continued to be used for an exempt
purpose. Note: If the county auditor restores all the property subject to the complaint to the taxable list, the auditor
need not forward the complaint to the tax commissioner.
2. If, after reviewing the complaint form, the county auditor decides not to restore all the property to the taxable list, the
auditor should forward two copies of the complaint to the tax commissioner, as directed below, and indicate in the
following Comments section which parts of the property, if any, were restored to the taxable list. The auditor may also
make a recommendation to grant or deny the complaint, and make any other comments that the auditor deems relevant
to the exempt status of the property contained in the complaint.
Auditors Recommendation Grant Partial grant Deny None
County auditor (signature) Date
Forward two copies of the completed application to the Ohio Department of Taxation, Equalization Division, P.O. Box 530,
Columbus OH 43216-0530.