Free DR-486A - Florida

ALTERNATIVE

petitioN to the VAlue ADjustmeNt boARD Request foR heARiNg
Do not use for portability of homestead assessment difference. Use form DR-486PORT. CompleteD by CleRk of the VAlue ADjustmeNt boARD
Petition # Tax Year 20___ Date filed Date received, if late

DR-486A N. 09/08

CompleteD by the petitioNeR
Taxpayer name Mailing address for notices Agent or attorney name If possible, I prefer to receive information by: (Check one) US mail e-mail ___________________________________________ Phone ____-_____-________
daytime

____-_____-________
other

fax _______-_______-__________ Physical address of property

Parcel or folio number County 1 to 4 residential units I wish to appeal my: (Check all that apply.) Real Property value Tangible Personal Property value Denial of classification Denial of request for exemption

All other property types

Denial of Agricultural or High-Water Recharge classification Disapproval of Affordable or Workforce Rental Housing classification

Denial for late filing for exemption Denial for late filing for agricultural classification Other ___________________________

How much time do you think you need to present your case to the Board?

_________ hours _________ minutes.

Are there specific dates you or your witnesses will not be available to attend a hearing? _____________________________________ Please send me a copy of the real property record card or tangible property worksheet with my hearing notice. I want all witnesses, including myself, to be sworn under oath before giving testimony at my hearing. CeRtifiCAtioN Under penalties of perjury, I declare that I am the owner of the property described in this petition or the authorized agent of the owner for purposes of filing this petition and for purposes of becoming agent for service of process under Section 194.011(3)(g), Florida Statutes, and that I have read this petition and the facts stated above are true. _______________________________________ Signature , Taxpayer or Agent ________________ ________________________________________________________ Date Print name Professional license number

CompleteD by CleRk of the VAlue ADjustmeNt boARD
I certify that this petition was timely filed with me, as the clerk of the Board, on ____/____/____ . My signing and delivery of a copy to the petitioner is a receipt of the petition. I certify that a copy has been provided to the Petitioner, and that a copy will be promptly furnished to the property appraiser, or to the tax collector for tax deferrals. ________________________________________________________________ Signature, Clerk of the Value Adjustment Board __________________________________ Date

Complete pAge 2 if you ARe submittiNg this petitioN AfteR the DeADliNe

ALTERNATIVE

DR-486A N. 09/08 page 2

eXplANAtioN foR submittiNg this petitioN lAte
For a hearing before the Value Adjustment Board I filed my petition late because:

________________________________________________________________ Signature , Taxpayer or Agent

__________________________________ Date

DeteRmiNeD by the VAlue ADjustmeNt boARD This taxpayer has has not shown good cause to accept the late-filed petition.

________________________________________________________________ Signature , Value Adjustment Board
use ADDitioNAl pAges, if NeeDeD

__________________________________ Date