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APPEAL FORM

BOARD OF ASSESSMENT APPEALS

ADAMS COUNTY, PENNSYLVANIA

INSTRUCTIONS:

Every question must be answered. If the question does not apply to your appeal, answer "N/A" (not applicable). Incomplete or illegible applications will be returned. A separate appeal form must be filed for each parcel involved in the appeal. Your appeal must be received by the Board of Assessment Appeals within forty (40) days from the mailing date of your Notice of Assessment. The fair market value appraisal you supply as evidence, should reflect current fair market value. You shall forward these appraisals to the Board within Twenty (20) days after filing your appeal. After the Board receives your appeal form, you will be notified of the date, time and place of your appeal hearing. NOTE: By appealing, you open your property to the revaluation process, in which your property's assessment may be lowered, raised, or remain the same. RETURN to: Board of Assessment Appeals, Adams County Courthouse, Room 202, 117 Baltimore Street, Gettysburg, Pennsylvania 17325, Telephone #717-337-9837, Fax #717-334-2091.

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Parcel Number: Municipality:

Appealed Assessed Valuation: Appealed Market Value:

Owner's(s') Name(s):

Owner's(s') Mailing Address:

Property Address:

Size of Lot: Acres OR Square Feet

Property Type: Check and Complete Proper Classification:

Residential: Year(s) Built Total Rooms Bedrooms Baths

Fireplaces Central Air Total Square Feet

Commercial: Use Year(s) Built

Gross Sq. Ft. Sq. Ft. Rentable Area Owner Occup.

Tenant Occupied If Leased: Annual Rent

Attach last 3 Years' Income & Expense Statements from Federal Income Tax Return.

Industrial: Year(s) Built Sq. Ft. Office Area Sq. Ft. Plant Area

Attach last 3 Years' Income & Expense Statements from Federal Income Tax Return.

Apartments: Year(s) Built No. of Units 100% Gross Annual Rent

Attach last 3 Years' Income & Expense Statements from Federal Income Tax Return.

Agricultural: (10 or more acres)

Are you appealing fair market value? Yes No

Are you appealing Clean and Green value? Yes No

(Continued on reverse side)

Owner's Opinion of Current Fair Market Value: $

Basis for Appeal (include all factors which you believe will be helpful in determining the true fair market

value):

Is your appeal based upon values of comparable properties in the area?

If so, list recent comparable sales (Note: Please list only local comparable properties which have been recently sold):

Parcel Selling Date of

Seller(s): Address Number Price Sale

1.

2.

3.

If you are going to be represented by an appraiser and/or legal counsel, please list:

Appraiser and Address: Phone Number:

Attorney and Address: Phone Number:

Check and attach copy of applicable property conditions:

Deed Restrictions Easements Flood Plain

Right-of-Way Other (explain)

Have any changes been made to the property after purchase?

Describe: Demolitions, New Construction, Additions, Remodeling, Repairs, etc.:

Year Cost $

Year Cost $

Year Cost $

The Undersigned represents that (please print and if this is a corporation, list name and title) is the property owner, attorney for the property owner, or corporate officer of the above-described property and affirms that all statements herein are true and correct to the best of his/her knowledge, information and belief.

I/WE THE UNDERSIGNED, INTENDING TO BE LEGALLY BOUND, HEREBY EXTEND THE TIME FOR THE RESPONSE BY THE ADAMS COUNTY BOARD OF ASSESSMENT APPEALS FOR THIS APPEAL.

Owner Signature Date

Owner Signature Date

Telephone: Home Business

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