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2. This form is used to appeal the taxable value of a vehicle based on an appraisal from an authorized vehicle dealer. The appraisal must be done by an authorized dealer. We cannot accept Carmax or other general dealers. An appeal must be signed by both the dealer representative and the owner, and received by the tax due date (last day of the month in which a tag expires).
4. Tax Payer Information:
6. Name*
7. Phone*
9. Receipt Number*
10. Assessed Value: $*
14. Vehicle Information
16. Year*
17. Make*
18. Model*
19. Tag #*
21. Vin #*
23. This information pertains only to the above described vehicle and in no way obligates the dealer or the vehicle owner
27. Dealer Information:
29. Dealer Name*
30. Date*
32. Address (city, state, zip)*
34. Dealer Estimate of Value*
36. Signature of Agent*
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field