Free Utah Tax Commission Petition for Redetermination, TC-738 - Utah

Before The Utah State Tax Commission PETITION FOR REDETERMINATION
Petitioner (print or type) Name D.B.A. Mailing address

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Petitioner representative, if any (print or type) I authorize the below-named person to discuss and share information concerning this appeal with the Utah State Tax Commission. Name Firm Mailing address

Daytime telephone no. Account/FEIN/Social Security no. Petitioner's email address

FAX telephone no. Property Parcel number Daytime telephone no. Representative's email address FAX telephone no.

Tax Type and Primary Issue This appeal involves (check any that apply) Sales/Use tax Penalty/Interest Individual income tax Refund request Corporate Franchise tax Motor vehicle or impound

(Provide estimated market value of property)

Property tax $____________________________ Other (specify): _____________________________

Tax year, audit period, or period under petition: _____________________________ This appeal involves an assessment, decision, or action by: Auditing Division Motor Vehicle Division Taxpayer Services Division Motor Vehicle Enforcement Division Property Tax Division Other (specify): _____________________________

If this appeal results from a decision, letter, assessment, or notice issued by a Division of the Tax Commission, provide the date of that action and the name and title of the person who took the action. (Attach a copy of any letter or notice to this petition.) Date: ___/___/___ Name and title: _______________________________________________________________________

If this appeal results from an impounded vehicle, provide the impound report number, license plate number and the vehicle identification number (VIN). Impound report no.: _______________ License plate no.: _________________ VIN: _______________________________________

Request For Relief Describe the basis for your appeal and the relief that you seek from the Tax Commission (attach additional pages if necessary)

Name (print)

Taxpayer's signature X

Date signed
TC-738 Rev. 12/06

Send Appeal Documents to: Utah State Tax Commission, Appeals Unit 210 North 1950 West Salt Lake City, Utah 84134 For assistance with this form, call: (801) 297-2280 or (801) 297-2281