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2. First Name*
3. Middle Name
5. Last Name*
6. Phone Number*
8. Email Address
10. Mailing Address*
12. City*
13. State*
14. Zip Code*
16. Property Owner's Name*
18. Property Address*
20. City*
21. State*
22. Zip Code*
24. Property Tax Map Number
25. Subdivision & Lot Number
27. Information Being Requested*

    *Select all that apply

    1. Current Tax Assessment Value and Tax Levy
    2. Formal Assessment Appeal
    3. Property Information - (i.e. Deed Reference, Sales Information, Property Location, etc.)
    4. Tax Map Number
    5. Owners Name and Mailing Address
    6. General Inquiry
29. Enter inquiry or comments/notes
31. Attach a File
33. Please contact us by phone at 804-633-9834 if you have not received a response within 48 hours.
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35. 1. Receive an email copy of this form.
36. Email address

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37. Submit

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