100 E Center Street, Suite 1100
Provo, UT 84606
Kris W. Poulson, Assessor
Krisp@utahcounty.gov
Phone 801-851-8244 Fax 801-851-8282
Request for Property Classification to be changed from
Primary Residential to Secondary Residential
PROPERTY OWNER INFORMATION
Property Owner(s) Name
Home Phone
Work Phone
Property Owner Address
City
State
Zip
PROPERTY INFORMATION
Property Parcel Serial Number for Subject Property
Tax Year
Location or Address of Subject Property
USE OF PROPERTY
Describe the Current Use of the Subject Property and State If You Have Personal Knowledge of Such Use:
Yes ___No___ Owner(s) currently resides on the Subject Property.
Yes___No___ Owner(s) spouse and children reside on the Subject Property.
Yes___No___ Owner(s) claims a residential property exemption on another property.
Yes___No___ Property is being leased to a tenant as a full time residence.
SIGNATURES
I understand that the Residence will no longer receive the benefit of the Primary Residential Exemption and will be taxed at full
market value.
Signature of Property Owner(s) Date
X
X
click to sign
signature
click to edit
click to sign
signature
click to edit