Fillable Event Speaker, Training and Special Assistance Request Form (Kansas Department of Revenue)

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Event Speaker, Training and Special Assistance Request Form (Kansas Department of Revenue)

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Reason for Needed Assistance (e.g., staffing issues, special use property,
additional/specialized staff training needed, etc.)
Description of Request
Requested Speaker (if interested in a particular PVD staff to present)
Desired Length of Presentation
Location of Event
phone: 785-296-2365
fax: 785-296-2320
Division Of Property Valuation
Zibell Building
300 SW 29
th
Street
PO Box 3506
Topeka, KS 66603-3506
ww
w.ksrevenue.org
Mark Burghardt, Secretary
Laura Kelly, Governor
Event Speaker, Training and Special Assistance Request Form
1. Requester Information (to be included on all request forms)
Organization
Contact Name and Title
Email Address Telephone Number
2. Event Speaker Request
Name/Title of Event
Date and Time of Event
Topic Description
3. Special Assistance or Training Request
Specific Date/Date Range Requested
Location of Assistance/Training
PV-AD-82 1
Rev 03/2019
FOR PVD USE ONLY
Receipt Date: Response Date:
Approved by:
Assigned to:
Preliminary Scope of Work:
Accepted: Y or N
Approval Date:
Summary of Task Completion:
Date(s) of Actual Presentation/Assistance:
Total Time (including prep, travel, etc.):
Total PVD Expense (mileage, lodging, per diem):
Amount Billed to Requestor:
Date
_______________________________________ ________________________
Specific PVD Staff Requested
Signature
Email completed request form to
kdor_pvd@ks.gov
2
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Event Speaker, Training and Special Assistance Request Form (Kansas Department of Revenue)

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Completed 24 August 2020

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