Ind. Tax. Ct. R. 23 app Petition for Original Tax Appeal of a Final Determination of [the Indiana Board of Tax Review or the Department of Local Government Finance]

As amended through November 4, 2024

Appendix - Petition for Original Tax Appeal of a Final Determination of [the Indiana Board of Tax Review or the Department of Local Government Finance]

IN THE INDIANA TAX COURT

CASE No.

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______________________	)
Petitioner,	)
	)
v.	)
	)
______________________	)
Respondent.	)
	)

PETITION FOR ORIGINAL TAX APPEAL

OF A FINAL DETERMINATION OF

[THE INDIANA BOARD OF TAX REVIEW OR

THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE]

[Name of Petitioner(s)], [by counsel or pro se], ("Petitioner(s)") bring(s) this Original Tax Appeal against Respondent, [Name of Respondent], requesting judicial review of a final determination of the [Indiana Board of Tax Review ("Board") or the Department of Local Government Finance ("Department")] and in support alleges as follows:

1. State the name and mailing address of Petitioner(s).

2. State the name and mailing address of the Respondent(s).

3. Attach a copy of the Final Determination from the issuing agency (the Board or the Department).

4. Summarize the issue(s) and conclusion(s) included in the Final Determination.

5. List the statute under which Petitioner is entitled to judicial review and the specific facts that meet the requirements of the statute listed.

6. State that the Petition for Original Tax Appeal is timely filed according to the applicable statutes and procedural rules.

7. State that a written notice of appeal has been filed with the Board if the appeal is from a final determination of the Board.

8. State that the Petitioner has requested the certified agency record from the Board or Department and that Petitioner shall file it with the Indiana Tax Court within thirty (30) days after Petitioner receives notification that it is prepared from the Board or Department according to Tax Court Rule 3(E).

9. Name the persons on whom Petitioner shall serve a copy of the Petition as required by the appropriate statute or procedural rule.

10. State specific facts that demonstrate that Petitioner has been prejudiced by one or more of the grounds described in IC 33-26-6-6.

WHEREFORE, Petitioner prays for judicial review of the Final Determination of the [Board or Department], for the Court to vacate and set aside the Final Determination, for the Court to remand this case for redetermination in accordance with its Order, and for all other just and proper relief [and further recite any additional or different relief, specifying the type and extent of relief requested].

/s/_______________________

Attorney's/Pro Se Litigant's Name,

Address, and

Indiana Attorney Number

CERTIFICATE OF SERVICE

[The name of each party served with this form should be identified, along with the date and method of service, and the name and signature of the person responsible for initiating service.]

Ind. Tax. Ct. R. 23 app Petition for Original Tax Appeal of a Final Determination of [the Indiana Board of Tax Review or the Department of Local Government Finance]

Adopted October 30, 2014, effective 1/1/2015; amended August 9, 2018, effective 9/1/2018.