Free TC-739, Petition for Expedited Hearing - Utah

Before the Utah State Tax Commission Petition for Expedited Hearing
PETITIONER: Name: ________________________________________ Daytime Phone: ________________________________ FAX: ________________________________________ Mailing Address _______________________________ _____________________________________________ PETITIONER=S REPRESENTATIVE (if any): Name:___________________________________________ Daytime Phone: ___________________________________ FAX: ___________________________________________ Mailing Address: __________________________________ ________________________________________________ I authorize the above-named person to discuss this Appeal with the Utah State Tax Commission. Yes
PRIMARY ISSUE: This appeal involves an assessment, decision, or action by:

No

9 Property Tax Division 9 Auditing Division Describe the primary issue: 9

9 Taxpayer Services Division 9 Motor Vehicle Enforcement Division 9 Motor Vehicle Division 9 Other _____________________________________ Factor Order 9 Certified Tax Rate 9 Other (Explain)

____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Reason for requesting expedited hearing: __________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________ If this appeal results from a decision, letter, assessment, or notice issued by a Division of the Tax Commission, state the date of that action and the name and title of the person who took the action. (Attach a copy of any letter or notice to this form.) _____ / _____ / _____ ________________________________________________________________________________________ Date Name and Title Section 59-1-501.5 of the Utah Code entitles the petitioning party to an Initial Hearing, with rights to pursue the matter further in a Formal Hearing. As the petitioning party, you may waive your right to the Initial Hearing and proceed directly to the Formal Hearing. Indicate your preference:

9

I waive the Initial Hearing

9

I request an Initial Hearing

REQUEST FOR RELIEF: Describe the basis for your appeal and the relief that you seek from the Tax Commission (attach additional pages if necessary):_______________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________________________ Signed: __________________________________________________ Date: ____________________________________________ Send Appeals Documents to: Utah State Tax Commission, Appeals Unit 210 North 1950 West SLC, UT 84134
TC-739 Rev. 10/04