Homeowners’ Association Special Valuation Application

Homeowners’ Association Special Valuation Application
Date Submitted: Date Submitted: / MM / DD YYYY
Parcel Number: *
Current Year: *
Name of Homeowners' Association: *
Phone Number: Phone Number: * - ### - ### ####
Mailing Address: Mailing Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Property Address: Property Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Provide Information On Total Land Owned By The Association
Number of Acres: *
Number of Lots: *
Number of Buildings: *
List Gross Receipts(Prior Year)

(Do Not include: dues, fees, or assessments from the members or developer’s contribution to the operation of the Homeowners’ Association).
Gross Receipts: * $ Dollars . Cents
Please Furnish A Copy Of The Homeowners’ Association Bylaws
Upload Bylaws: *

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Attach Files
Homeowners’ Association Officer Information

Please upload a list of all Officers, and list their Name, Address, Phone Number, and Position.
Upload List of Officers: *

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Attach Files
Application Must Be Received By The County Assessor Before January 15th (1st Penalty Date) For The Prior Tax Year.

Failure To Do So Constitutes A Waiver Of Special Valuation For That Year.
Who is filling out this application? *

Who is filling out this application? Property Owner Authorized Agent
An individual who is not the legal property owner must provide documentation to substantiate their relationship to the owner(s) or legal interest in the property at the time of submission. the three forms of acceptable proof are:

1. Copy of power of attorney for the owner of record.
2. Copy of completed poa39 by owner of record.
3. Copy of personal representative appointment by probate court.
Proof Of Authorization To Sign:

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Attach Files
Relationship to Owner: *
Agent's Mailing Address: Agent's Mailing Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email Address: *

Confirm Email Address: *
Sign in the box below:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Homeowners’ Association Special Valuation Application

Homeowners’ Association Special Valuation Application

Homeowners’ Association Special Valuation Application

Provide Information On Total Land Owned By The Association

List Gross Receipts(Prior Year)

Please Furnish A Copy Of The Homeowners’ Association Bylaws

Homeowners’ Association Officer Information

Application Must Be Received By The County Assessor Before January 15th (1st Penalty Date) For The Prior Tax Year.

An individual who is not the legal property owner must provide documentation to substantiate their relationship to the owner(s) or legal interest in the property at the time of submission. the three forms of acceptable proof are: