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2. Address Being Appealed
4. Parcel #
6. Address
8. City
   -- Select One --CentertownHenlyJefferson CityLohmanRussellvilleSt. MartiansSt. Thomas
9. State
10. Zip Code
14. Contact Information
16. First Name
17. Last Name
19. Address
21. City
    -- Select One --CentertownHenlyJefferson CityLohmanRussellvilleSt. MartiansSt. Thomas
22. State
23. Zip Code
25. Phone Number
26. Email Address
30. Reason For Appeal
32. Reason for Appeal

    (Ex. Value, Classification, etc.)

33. If Value is the reason for appeal, what is owner's opinion of value?

    (Ex. 50,000, 100,000, etc.)

35. How did you determine Value?
39. Property Purchase Information
41. Date Property Acquired
    Date Property Acquired

    Date Property Acquired
42. Purchase Price
44. How was Property Acquired

    (Ex. Purchased, Foreclosure, Inherited, etc.)

45. Is the purchase price reflective of market value?

    1. Yes
    2. No
47. If not, why?
51. Most Recent Appraisal By Certified Appraiser
53. Appraisal Date
    Appraisal Date

    Appraisal Date
54. Appraised Value
58. House Information
60. Number of Story Levels
    -- Select One --1 Story - Standard1.5 Story - Partial 2nd Story2 Story - Split Level2 Story - Full 2nd Level2.5 - Partial 3rd Story3 Story - Full 3rd Level3.5 Story - Partial 4th Story

    (Excluding Basement Level)

61. Finished Square Footage

    (Excluding Basement Level)

63. Number of Bedrooms
    -- Select One --12345678910
64. Number of Full Baths
    -- Select One --12345678910

    (sink, toilet, bathtub & separate shower)

65. Number of Half Baths
    -- Select One --12345678910

    Combinations that equal a Half Bath

    Toilet & Sink or Toilet & Bath or Toilet & Shower

69. Basement
71. Is there a basement

    1. Yes
    2. No
72. Does Basement have a door exiting to outside

    1. Yes
    2. No
73. Finished Basement Square Footage
74. Basement built in Garage car storage count
    -- Select One --1 Car Basement2 Car Basement3 Car Basement4 Car Basement 5 Car Basement6 Car Basement7 Car Basement8 Car Basement9 Car Basement10 Car Basement
78. Garage(s)
80. Attached Garage Count
    -- Select One --1 Car Attached Garage2 Car Attached Garage3 Car Attached Garage4 Car Attached Garage5 Car Attached Garage6 Car Attached Garage7 Car Attached Garage8 Car Attached Garage9 Car Attached Garage10 Car Attached Garage

    (Amount of garage doors)

81. Detached Garage Count
    -- Select One --1 Car Detached Garage2 Car Detached Garage3 Car Detached Garage4 Car Detached Garage5 Car Detached Garage6 Car Detached Garage7 Car Detached Garage8 Car Detached Garage9 Car Detached Garage10 Car Detached Garage
85. Major Improvements Or Additions Made to Property
87. Please list EACH improvement and date performed as well as Each addition(s) and date performed

    An on-site inspection of the property may be required to verify the: Measurement of new addition, Current quality, or Current condition

89. Please indicate the best time to contact you
    Please indicate the best time to contact you

    Please indicate the best time to contact you

    Between the hours of 8:00am - 4:30pm (Monday – Friday), to schedule an appointment for interior inspection of the property. 

91. Date this document was submitted
    Date this document was submitted

    Date this document was submitted
Leave This Blank:


93. 1. Receive an email copy of this form.
94. Email address

    This field is not part of the form submission.

95. Submit

* indicates a required field