Free BEFORE THE BOARD OF TAX APPEALS OF THE STATE OF KANSAS - Kansas

BEFORE THE COURT OF TAX APPEALS OF THE STATE OF KANSAS MORTGAGE REGISTRATION PROTEST (K.S.A. 79-3107c) APPLICANT: __________________________________________ Applicant Name __________________________________________ Applicant Address (Street or Box No.) __________________________________________ City State Zip

(For State of Kansas use only)

DOCKET NO.__________________-MRP
Applicant Phone #:(____)_____________________ Applicant E-mail: ___________________________ Fee:_____________ Rec. Date:________ ATTORNEY OR REPRESENTATIVE: (If applicable)* No Fee:__________ __________________________________________ Representative Name Title __________________________________________ Representative Address __________________________________________ City State Zip Atty/Rep Phone #:(_____)_____________________ Representative E-mail:________________________
*Note: If you are represented by an attorney or other individual, you must provide the Court with either an Entry of Appearance or a current Declaration of Representative form approved by the Court of Tax Appeals. Tax Representatives are not permitted to sign applications filed with the Court.

Amt Rec.__________ Ck #______________ Reason: ___________

(For County use only)

Date Protest Received:___________________ Date Document Recorded:________________ Mortgage Reg. Fee Paid: _________________ Book: _____________ Page: _____________ Book: _____________ Page: _____________ Hearing requested: _____Yes _____No

Taxing County:_____________________________ Year/Years at issue: _________________________ Property at issue:

Register of Deeds initial: _________________

Real Property---Street address, city:_________________________________________________

CTA-MRP (Rev. 7/08)

Mortgage Registration Protest Page 2 of 3

1. Name of Mortgagor: ________________________________________________________________

2. Type of Document(s) Recorded: (Attach a copy of each document.) _________________________________________________________________________________ _________________________________________________________________________________ 3. Amount of mortgage registration protested by applicant: $__________________________________ 4. Is the property located in more than one county? No _____ Yes_____ If "yes", list counties:____________________________________________________________ 5. Explain why you are filing a protest on all or any part of the mortgage registration fee and the statute, law, or facts on which your protest is based. (Attach additional explanation if necessary.) _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 6. Do you request a hearing on this application? No _____ Yes_____

VERIFICATION

I, ________________________________, do solemnly swear or affirm that the information set forth herein is true and correct, to the best of my knowledge and belief. So help me God.

_____________________________________ Signature of Applicant _____________________________________ Printed Name and Title State of ____________________ County of __________________ ) )

This instrument was acknowledged before me on __________ by ______________________________.

Seal

_____________________________________ Signature of Notary Public

My appointment expires: ________________

Mortgage Registration Protest Page 3 of 3

MORTGAGE REGISTRATION PROTEST INSTRUCTIONS

K.S.A. 79-3107c. "Mortgage registration fees; protest of payment, procedure. (a) Any person, before protesting the payment of mortgage registration fees, shall be required, within 30 days after the time of paying such fees, to file a written protest statement with the register of deeds, on forms...provided by the register of deeds, clearly stating the grounds on which the whole or any part of such fees are protested and citing any law, statute or facts upon which such person relies in protesting the whole or any part of such fees. The register of deeds shall forward a copy of the written statement of protest to the county treasurer and to the state court of tax appeals within 15 days of the receipt thereof."

1. The Court of Tax Appeals is required to set the matter for hearing unless both parties (the County Register of Deeds and the applicant) waive their right to a hearing and agree to submit the matter in writing to the Court. 2. The Court will schedule a hearing no later than 90 days after receipt of the protest; however, the hearing will not necessarily be held within 90 days. The hearing will be conducted in accordance with the Kansas Administrative Procedure Act. 3. Enclose any applicable filing fee(s) pursuant to K.A.R. 94-2-21. Checks or money orders should be made payable to the Court of Tax Appeals. For information regarding Court of Tax Appeals filing fees visit www.kansas.gov/cota/ or contact the Court at (785) 296-2388.

This form along with the applicable attachments and filing fee of $15.00 is to be filed with the Register of Deeds. The Register of Deeds will forward the application and fee to the Court of Tax Appeals.