DR-485WI (Withdrawal of Petition) - dated 12/09 FLORIDA VALUE ADJUSTMENT BOARD D N-48�I
WITHDRAWAL OF PETITION Rule 12D-16.002
Florida Administrative Code
w 1-4
DEPARTMENT
OF REVENUE To the value adjustment board of County
Address
From ❑ Taxpayer ❑ Agent
Parcel ID Petition#
Property Mailing
address address
Email Phone
I do not wish to have a decision entered by the board or special magistrate. I understand that
withdrawing this petition may mean I lose my right to file an appeal of the assessment in circuit court.*
The petition is withdrawn for the reason below.
❑ The petitioner agrees with the determination of the property appraiser or tax collector.
❑ The petitioner and property appraiser or tax collector have reached a settlement.
Value settled on$
❑ The petitioner does not agree with the decision or assessment of the property appraiser or tax collector
but no longer wishes to pursue a remedy through the value adjustment board.
❑ Other reason, specify:
OR
Signature,taxpayer Signature,petitioner or agent
If signed by agent, I am authorized to withdraw this petition.
Print name Date Print name Date
*If you are not satisfied after you are notified of the final decision of the VAB, you have the right to file a lawsuit in circuit
court to further contest your assessment(sections 193.155(8)(1), 194.036, 194.171(2), and 196.151, F.S.).