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PETITION TO THE INDIANA BOARD OF TAX REVIEW FOR REVIEW OF ASSESSMENT
State Form 42936 (R7 / 2-09) / IBTR Form 131
Prescribed by the Indiana Board of Tax Review

FORM 131
THIS PETITION MUST BE FILED WITH THE INDIANA BOARD OF TAX REVIEW
PETITION NUMBER
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1

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Co.

Dist.

Yr.

Prop. Class

Sequence

READ IMPORTANT FILING INFORMATION BEFORE COMPLETING THIS FORM FILING INFORMATION
This petition must be filed with the Indiana Board of Tax Review at its central office, 100 North Senate Avenue, Room N-1026, Indianapolis, Indiana 46204. A copy of this petition must be served on the county assessor of the county where the property is located. If this petition is filed by the county assessor, a copy must be served on the taxpayer. Ind. Code § 6-1.1-15-3(d). WHO MAY FILE THIS FORM: This form may be used by taxpayers and by county assessors who dissent from the determination of the county property tax assessment board of appeals to appeal assessments of real and personal property. Ind. Code § 6-1.1-15-3(a) and (c). FILING DEADLINE: This petition must be filed not later than 45 days after the Notification of Final Assessment Determination is given to the taxpayer. Ind. Code § 6-1.1-15-3(d). MULTIPLE PARCELS OR TYPES OF PROPERTY: Petitioners wishing to appeal more than one parcel must file a separate petition form for each parcel unless the Indiana Board of Tax Review determines otherwise. Petitioners wishing to appeal both personal and real property assessments for the same parcel must complete a separate petition form for each type of property. Please attach a list of related parcels currently under appeal. ATTACHMENTS TO THIS PETITION: A copy of the written notice filed with the county or township assessor to initiate this appeal and a copy of the Notification of Final Assessment Determination (State Form 20916 / Form 115) must be attached to this petition.

GENERAL INSTRUCTIONS
1. Please print or type. 2. The Petitioner must complete Section I, Section II, Section III, Section IV, and Section V of this petition. 3. The petition must be signed by the Petitioner or an authorized representative. A representative must attach a notarized power of attorney unless the representative is an attorney licensed to practice law in Indiana, or a duly authorized employee or corporate officer of the taxpayer. Yes No Is a power of attorney attached? 4. Certified Tax Representatives must attach a Tax Representative Disclosure Statement. 52 IAC 1-2-2. 5. Notify the Indiana Board of Tax Review and the county assessor of any change in your mailing address or telephone number subsequent to filing this petition. FAILURE TO FOLLOW INSTRUCTIONS: If the Petitioner does not comply with the instructions for completing this petition, the Indiana Board of Tax Review will return the form to the Petitioner with a description of the defect. The Petitioner will then have 30 days from the date of notice of defect to correctly complete the form and resubmit it to the Indiana Board of Tax Review. If the resubmitted form does not comply with the instructions for completing the form, the Indiana Board of Tax Review may deny the petition. Please complete the checklist provided on page 3 before submitting this petition. As a result of filing this petition, the assessment may increase, may decrease, or may remain the same.

Check the type of property under appeal (check only one ): Is this property currently under appeal for another tax year?

Real Yes

Personal No

If yes, indicate year(s) and type of appeal(s): _____________________________________________________________________ SECTION I: PROPERTY AND PETITIONER INFORMATION
County Township Parcel or Key number (for real property) City ZIP Code

Address of property (number and street or rural route)

Legal description provided on Form 11 or Property Record Card (for real property) , or business name (for personal property) Assessment year under appeal

MARCH 1, ______________
Name of property owner Address of property owner (number and street or rural route) Name of authorized representative (if different from taxpayer) Address of authorized representative (number and street or rural route) City City Area code and telephone number of property owner

(

)
State ZIP Code

Area code and telephone number of authorized representative

(

)
State ZIP Code

Form 131, page 1

SECTION II: SMALL CLAIMS OPTION NOTICE: If your property is assessed at less than $1,000,000, you may elect to have this petition processed as a small claim and administered under the Indiana Board of Tax Review (IBTR) rules governing small claim petitions. You are strongly encouraged to review both the small claims rules and the more formal procedural rules governing non-small claims*, available on our website at http://www.in.gov/ibtr/, before making the election below. * IBTR rules are authorized by Indiana Code § 6-1.5-6-1 and 2, and are published in the Indiana Administrative Code at 52 IAC 2 and 3. PLEASE READ THE FOLLOWING PARAGRAPHS CAREFULLY AND INDICATE YOUR DESIRED ELECTION BY CHECKING ONE OF THE TWO BOXES BELOW. By checking the box indicating acceptance of the small claims process, the undersigned Petitioner agrees that the administration of this petition shall be conducted under the IBTR's rules and procedures for small claims. The small claims procedures are designed to expedite the petition review process. In order to accomplish that goal, the process necessarily places restrictions and limitations on how the proceedings may be conducted. By this election, the Petitioner specifically agrees to, and accepts, the restrictions and limitations specified by the IBTR small claims procedures. ACCEPT SMALL CLAIMS Initial By checking the box to opt-out of the small claims process, the undersigned Petitioner agrees that the administration of this petition will be conducted in a more formal adjudicatory fashion under the IBTR's rules and procedures for non-small claims hearings. Formal hearings require significant time and resources and typically are not resolved as quickly as small claims. The non-small claims hearing procedures involve, among other things, the availability of discovery conducted under the Indiana Rules of Trial Procedure. By making this election, the Petitioner agrees that the petition will be subject to the IBTR's procedures governing non-small claims. See 52 IAC 2. OPT-OUT OF SMALL CLAIMS Initial

SECTION III: GROUNDS FOR APPEAL
Land Improvements Personal Property

The property described in SECTION I is currently assessed at: The Petitioner contends that the property should be assessed at:

$ $

$ $

$ $

For All Appeals:
Please explain in detail the basis of your belief that the assessed value is incorrect. Please be careful not to simply state conclusions such as the "assessment is too high" or "the assessment is wrong," but provide specific reasons for your belief. Failure to provide sufficient detail may result in your petition being returned to you for correction under the provisions of Indiana Code § 6-1.1-15-4. You are not required to submit any evidence with your petition. However, specific evidence, fully supporting the assessment that you believe to be correct, must be presented at the hearing. Basis of belief that assessment is incorrect:

Form 131, page 2

SECTION IV: SIGNATURES PETITIONER, TAXPAYER, OR DULY AUTHORIZED EMPLOYEE OR CORPORATE OFFICER OF THE TAXPAYER I certify that my entries in SECTION I and SECTION III are accurate to the best of my knowledge and belief. I also understand that by appealing my assessment, my assessment may increase, may decrease, or may remain the same.
Signature of petitioner, taxpayer or duly authorized officer Printed or typed name of petitioner, taxpayer or duly authorized officer Date signed (month, day, year) Title (please print or type)

TAX REPRESENTATIVE I certify that the entries in SECTION I and SECTION III are accurate to the best of my knowledge and belief. I certify that I have viewed this property, the property record card, and State Form 20916 / Form 115, and that I have the authority to file this appeal on behalf of the taxpayer. I certify that I have made all necessary disclosures to my client, pursuant to 52 IAC 1-2-2.
Signature of tax representative Printed or typed name of tax representative Date signed (month, day, year)

ATTORNEY REPRESENTATIVE I certify that the entries in SECTION I and SECTION III are accurate to the best of my knowledge and belief.
Signature of attorney representative Printed or typed name of attorney representative Date signed (month, day, year) Attorney number

SECTION V: CERTIFICATE OF SERVICE I affirm under the penalties of perjury that a copy of this petition has been served on the following via First Class United States Mail, postage, prepaid, this ____________ day of ________________, 20_____.
If this petition is filed by the county assessor

County Assessor:

Taxpayer:

Signature

FORM 131 CHECKLIST I have attached the Notification of Final Assessment Determination (State Form 20916 / Form 115). I have attached a copy of the written notice filed with the county and township assessor to initiate this appeal. If I am appealing both real property and personal property assessments, I have filed separate petitions for each type of property. I have checked the type of property under appeal (real or personal) on page 1. I have identified any other pending appeals for this parcel on page 1. If there are other related parcels currently under appeal, a listing of these parcels has been attached. I have reviewed Section II, selected a small claims option, and initialed. I have explained in detail the basis for my belief that the assessment is incorrect (Section III). If this petition is being filed by an authorized tax representative, a duly executed power of attorney and a Tax Representative Disclosure Statement are attached. I have completed Section I, Section II, Section III, Section IV, and Section V of this petition. I have signed this petition (Section IV). I have served a copy of this petition on the other party (Section V).

Information regarding appeal procedures and hearing practice is available on the IBTR website located at www.in.gov/ibtr/.
Form 131, page 3