PETITION FOR REVIEW OF NOTICE OF CHANGE
INSTRUCTIONS: PURSUANT TO A.R.S. §§ 42-15105, 42-16105, 42-16108, 42-16157, 42-16165 & 42-16205
• IN MARICOPA AND PIMA COUNTIES: File this petition with the STATE Board of Equalization
(SBOE) located at 100 N. 15th Avenue, Suite 130, Phoenix, AZ 85007.
• IN ALL OTHER COUNTIES: File this petition with the COUNTY Board of Equalization.
• This petition must be fi led within twenty-fi ve days after the date of the Assessor’s Notice of Change.
• Provide a copy of any additional information being submitted to either the County or State Board of Equalization. Keep a copy of
this form and all information submitted to the Board for your records.
• The County or State Board of Equalization must rule on all appeals on or before the third Friday in November. If the petitioner is
dissatisfi ed with the County or State Board of Equalization’s decision, an appeal with the Superior Court or Tax Court must be fi led
within sixty days of any administrative appeal decision.
• IMPORTANT: PETITIONER MUST COMPLETE SECTIONS 1 THROUGH 11 WHERE APPLICABLE. PLEASE TYPE OR PRINT.
1. DATE FILED _____________ COUNTY _________________________________________ BOOK / MAP / PARCEL ___________ - _________- ____________
2. PROPERTY ADDRESS OR LEGAL DESCRIPTION: _____________________________________________________________________________________________
3. IF MORE THAN ONE PARCEL IS INVOLVED IN THE APPEAL CHECK THIS BOX . ATTACH A MULTIPLE PARCEL APPEAL FORM (DOR 82131).
4. USE OF PROPERTY: RESIDENTIAL (OWNER OCCUPIED) RESIDENTIAL (RENTAL) VACANT LAND
AGRICULTURAL COMMERCIAL / INDUSTRIAL SPECIFY (OFFICE, WAREHOUSE, ETC.) _______________________________
5A. OWNER’S NAME AS SHOWN ON THE NOTICE OF CHANGE 5B. MAIL DECISION TO: (IF DIFFERENT FROM 5A)
________________________________________________________________ ______________________________________________________________
________________________________________________________________ ______________________________________________________________
_________________________________________________________________ ______________________________________________________________
6. PETITION COMPLETED BY: (Specify Owner, Agent, Attorney, etc.)
NAME / COMPANY NAME __________________________________________________________________________ TELEPHONE ___________________________
ADDRESS ______________________________________________________________ CITY ____________________________ STATE __________ ZIP _________
AGENTS ONLY: Include a copy of a current Agency Authorization Form (82130AA) with this petition.
State Board of Appraisal Registration Number ______________________ SBOE Number__________________ (PIMA AND MARICOPA COUNTIES ONLY)
7. BASIS FOR THIS PETITION: Provide evidence for appealing the Assessor’s Notice of Change. Include the book, map and parcel number(s) of
other properties used in your appeal. Specify if the appeal is based upon one or more of the following methods of valuation:
MARKET SALES APPROACH COST APPROACH INCOME APPROACH
8.
9.
10.
11. I HEREBY AFFIRM THAT ALL THE INFORMATION HEREIN IS TRUE AND CORRECT.
X _________________________________________________________________
SIGNATURE OF PROPERTY OWNER OR REPRESENTATIVE
TELEPHONE ________________________________________________________
12.
13. BASIS FOR DECISION:
ORIGINAL
VALUE
FULL CASH
VALUE $
AMENDED
VALUE
FULL CASH
VALUE $
LIMITED
PROPERTY $
VALUE
LIMITED
PROPERTY $
VALUE
OWNER’S OPINION
OF VALUE
FULL CASH
VALUE $
LIMITED
PROPERTY $
VALUE
LEGAL
CLASS
ASSMT.
RATIO
LEGAL
CLASS
LEGAL
CLASS
ASSMT.
RATIO
ASSMT.
RATIO
IN PIMA AND MARICOPA COUNTIES ONLY: Check here
if you want this appeal to be heard “On The Record”. This
means that neither you nor the Assessor will appear in person
before the State Board of Equalization to offer oral testimony.
Submit any additional written or typed information with this
form.
COUNTY BOARD
OF
EQUALIZATION
FULL CASH
VALUE $
LIMITED
PROPERTY $
VALUE
LEGAL
CLASS
ASSMT.
RATIO
DATE RECEIVED DATE DECISION MAILED CHAIRMAN OR CLERK OF THE BOARD
DOR 82130NC (11/09)
FOR OFFICIAL USE ONLY
FOR OFFICIAL USE ONLY
FOR OFFICIAL USE ONLY
