50-171-1(9-93) [25.11 (4-82)]
YEAR
REQUEST FOR SEPARATE TAXATION OF AN UNDIVIDED INTEREST
Appraisal district name Address Phone (area code and number)
To qualify for the taxation of an undivided interest in property separate from other undivided interests in the property, the owner of the undivided interest must submit this request form to the chief appraiser for the appraisal district in which the property is located between January 1 and April 30 of this tax year. In addition, the applicant must prove separate ownership by supplying the chief appraiser with the following documents:
Step 1: Owner's name and address
Owner's name
Current mailing address (number and street) City, town or post office, state, ZIP code Phone (area code and number)
What proportion of the property described in this request is owned by this property owner?
Description of property: ________________________________________________________________________________________________
Step 2: Describe the Property
Address or location of property: __________________________________________________________________________________________
Authorized agent (if different from above)
Step 3: Agent's name and address
Current mailing address (number and street) City, town or post office, state, ZIP code
Step 4: List owner's name and address (attach additional pages if necessary)
Please list the names and addresses of all persons who own an interest in the property described in this request.
Owner's name Current mailing address (number and street) City, town or post office, state, ZIP code
Owner's name Current mailing address (number and street) City, town or post office, state, ZIP code
Owner's name Current mailing address (number and street) City, town or post office, state, ZIP code
Owner's name Current mailing address (number and street) City, town or post office, state, ZIP code
Form 50-171-2 (9-93) [25.11 (4/82)]
Step 5: Sign the form
I hereby affirm that I own an undivided interest in the herein-described property in the proportion stated in this request. I hereby request that my undivided interest in the specified property be listed on the appraisal records of the appraisal office separately from any remaining undivided interest.
I certify that the information given on this form is true and correct to the best of my knowledge and belief.
sign here ±
Signature
Date