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REQUEST FOR REVIEW OF REAL ESTATE ASSESSMENT AND DECLARATION OF VALUE BY OWNER TO THE COUNTY ASSESSOR OF CROW WING COUNTY, MINNESOTA: Telephone Number: (218) 824 -1010 Fax Number: (218) 824 -1011 being first duly sworn, deposes and says that _he resides at Owner of the following described real estate situated in the City Township of County of Crow Wing, State of Minnesota, to -wit: Parcel Number(s): Legal Description: 02"�, 10`70C? v O / -Moo The above referenced property was purchased on for the sale price of $ That this sale did did not include personal property valued in the amount of $ That since the time of purchase, alteration, additions, remodeling, etc. have been done at a cost of $ The structures on said property are insured for the sum of $ The affiant believes that said property could not have been sold at private sale for more than $ that he is the in said That an error was made in assessing said property for said year and in equalizing said assessment, and that _ he is informed and believes that said error occurred because (state specific reasons): 6-6-1 5 f {f- U(= That affiant did did not County of Crow Wing on _ �' (,�— _� n.. dv,OO 6ct— — appear at the local board of appeal in the town/city of 20 in the That no proceedings of any kind, for the correction of the assessment of said property, are now pending in any court; and that Foregoing is a full and true statement of all facts relative to said matter of which affiant has any knowledge. It is also understood that when a review of the property is completed, the changes may result in a decrease or an increase or no change at all. IMPORTANT In order to complete this review request, please indicate preferred method of review. (If no indication is made, this form will not be acted upon and will be placed in an inactive file.) _ (1) Anytime appraiser is in area. (2) I will call later for appointment. (3) Aerial Photo Review (land only) Signature of Affiant Date Phone # Form given by // (,J j ' Y-0 -I (Initials /Date) SM.S.A. Section 620.05, FALSE STATEMENT REGARDING TAXES — Every person who in making any statement, oral or vritten which is required or authorized by law to be made as a basis of imposing or reducing any tax or assessment, who shall willfully make any statement as to any material matter which he knows to be false shall be guilty of a gross misdemeanor. This form must be received in Assessor's office by 8:00 AM on (Meeting Date)