50-127 (Rev. 9-99/6) [22.03 (8/88) Rule 9.3015]
CONFIDENTIAL
YEAR Phone (area code & number)
REPORT OF DECREASED VALUE
Appraisal district name Address
This application covers property you owned on January 1 of this year. If you believe the property's appraised value decreased during the preceding tax year for any reason other than normal depreciation, you must file this completed form after January 1 and not later than April 15 of this year. You may ask for additional time if you can show good cause to the chief appraiser. Return the completed form to the address above.
Owner's name
Step 1: Owner's name and address
Present mailing address (number and street) City, town or post office, state, ZIP code Phone (area code and number)
Legal description:
Step 2: Describe the property
Taxing units in which property is located:
State the property's market value (optional)
$
Explain in detail the cause of the value decrease and how it affected the property's value.
Step 3: Sign the application
Are you the property owner, an employee of the property owner, or acting on behalf of an affiliated entity of the property owner? Yes No The application must be signed and dated. By signing this document, you attest that the information contained on it is true and correct to the best of your knowledge and belief. If you checked "Yes" above, sign and date the application.
sign Signature here __________________________________________________________________ Date _________________
If you checked "No" above, you must complete the following: I swear that the information provided on this form is true and accurate to the best of my knowledge and belief.
sign Signature here __________________________________________________________________ Date _________________
I attest that the individual signing above subscribed and swore to the accuracy and truth of the information provided on this form before me, this the ______ day of ________________ , ______ . _________________________________________
Notary Public On behalf of (name of owner) For additional information about this property, contact (name) Present mailing address (number and street) City, town or post office, state, ZIP code Phone (area code and number) Title
Any person who makes a false entry upon the foregoing record shall be subject to one of the following penalties: 1. imprisonment of not more than 10 years nor less than 2 years and/or a fine of not more than $5,000 or both such fine and imprisonment; 2. confinement in jail for a term up to 1 year or a fine not to exceed $2,000 or both such fine and imprisonment as set forth in Section 37.10, Penal Code.
50-127 (Rev. 9-99/6) [22.03 (8/88) Rule 9.3015] (Back)
FOR APPRAISAL DISTRICT USE
Reviewer Title
Real property Personal property Date property was viewed
Oil or gas property
Date appraisal was reviewed
Reviewer`s determination: