PT- RR www.hctax.net Rev 7/17 v5
Research Request Form
Please complete the entire form.
PROPERTY INFORMATION
*Account Number(s):
Certified Owner:
Property Address:
CUSTOMER CONTACT INFORMATION
* Requestor Name:
Email Address:
* Daytime Phone:
Mobile Phone:
Mailing Address: (if different from Property Address)
Please check the one that applies to you and provide the information requested:
*Tax Year(s):
Penalty/Interest Issues: (Justify request)
Transfers : (Payment Corrections, Movement of Funds)
Lost Checks: (Payment Information)
Postmark: (Date Mailed)
Other: (Details)
Please describe in detail the type of research you are requesting:
You may attach or fax any additional information to help resolve this matter. Please place the account
number and name on all pages.
* Customer Signature: Date:
* Indicates required field.
Mail information to: PO Box 4663 Houston, TX 77210-4663
or fax to: 713-368-2219
or email to: tax.office@hctx.net
Tax Assessor-Collector & Voter Registrar
ANN HARRIS BENNETT
click to sign
signature
click to edit