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FOR BOARD 

Rowton 

OF REVIEW USE ONLY 

: Incorporate a Copy 

of this form and the assigned number in the Board of Review minutes 

MBR-007 

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Ha 

ro Hina. 

| 

not 

nou gh uns 

tsi Mergen Tox Tru. | 

of he Board 

of Review. 

ow 

be hed | 

VE TAX 

SAAELE 

VAIL 

E 

by 

f Review The Boar 

of Review must iste te reason fr As acon below 

[J veniea 

[7 Tentative Taxate vaiue Changed From 

® 

(See attached L4035A) 

[Dyes [Ine 

“initials 

You may appeal thet decision by filing 8 petition with the 

L 

PORN Mat be led on a Mchigen Tax Toul fom o 

far soprered oy bs chan Tex 

= Slofaoac