Free 49585.FH11 - Indiana

NOTICE OF ACTION ON EXEMPTION APPLICATION
State Form 49585 (R3 / 3-07) Prescribed by the Department of Local Government Finance

FORM 120

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NOTES:

This is a notice of action on an exemption application by the County Property Tax Assessment Board of Appeals as provided for pursuant to IC 6-1.1-11-7. If you do not agree with the action of the County Property Tax Assessment Board of Appeals, the Indiana Board of Tax Review will review that action if you file a Form 132 petition with the County Assessor of this county WITHIN THIRTY (30) DAYS of the mailing of this notice. See IC 6-1.1-15-3.

Please check type of property under application:
Name of Property Owner / Petitioner (first, middle, last)

Real

Personal

Both

SECTION I: PETITIONER INFORMATION

Address of Property Owner (number and street)

City

State

ZIP code

Name of Licensed Attorney

Address of Licensed Attorney (number and street)

City

State

ZIP code

SECTION II: DESCRIPTION OF PROPERTY
County Township Parcel of key number

Address of property (number and street)

City

State

ZIP code

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

SECTION III: FINAL DETERMINATION

You are hereby notified that your application for a property tax exemption for the property described above has been acted upon by the _________________________________________________ County Property Tax Board of Appeals in the following manner: March 1, __________ assessment date Land Improvements Personal Property THE COUNTY PROPERTY TAX ASSESSMENT BOARD OF APPEALS SHALL COMPLETE SECTIONS IV AND V OF THIS FORM. See IC 6-1.1-11-7. (Notice of action by the County Property Assessment Board of Appeals; action by County Assessor and County Auditor; Appeal)
Date when notification was mailed (month, day, year) Signature of County Assessor

% Exempt

% Taxable

Total

Form 120, page 1 of 2

SECTION IV: DETERMINATION BY COUNTY PROPERTY TAX ASSESSMENT BOARD OF APPEALS

The County Property Tax Assessment Board of Appeals determination is based on the following reasons. This statement should include cites to applicable statutes, regulations, or case law in support of this determination.

SECTION V: SIGNATURES
Signature of County Property Tax Assessment Board of Appeals member Date signed (month, day, year)

Signature of County Property Tax Assessment Board of Appeals secretary

Date signed (month, day, year)

Form 120, page 2 of 2