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2. California Revenue and Taxation Code Selection:*
   -- Select One --R&TC Section 2512 - Proof the United States Postal Service took custody of the paymentR&TC Section 4911 - Payment was made to an incorrect propertyR&TC Section 4985 - An error expressly made by the County of NevadaR&TC Section 4985.2 - Beyond taxpayer's control

   Please select the California Revenue and Taxation Code Section, which you believe supports your request for penalty cancellation.
4. Bill Type*
   -- Select One --Annual Secured Property Tax BillSupplemental Secured Property Tax BillAdjusted Annual Property Tax BillAdjusted Supplemental Property Tax BillStatement of Prior Year TaxesUnsecured Property Tax Bill
5. Tax Year (i.e., 2019)*
7. Annual Secured Property Tax Bill Assessor's Identification Number:
   A 12 digit number assigned to a piece of real property. This number is found on your Annual Secured Property Tax Bill. Only use numbers
8. Unsecured Assessment Number
   A 12 digit number found on your Unsecured Property Tax bill. Only use numbers.
10. Taxpayer Name:*
12. Mailing Address:*
13. Address 2 (optional):
15. City:*
16. State:*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
17. Zipcode:*
19. Phone Number:*
21. Email Address:*
23. Notes:
    Please enter, optionally, a brief description of the nature of your request for penalty cancellation. Please note this field is limited to 500 characters, including spaces, returns, and other system control characters.
25. Upload Supporting Documents
27. Upload Additional Supporting Documents
29. Upload Additional Supporting Documents
31. Confirmation*

    1. Check the box to declare and sign

    I declare under penalty of perjury that the information contained in this claim is true and correct and that I am signing as the assessee of record or his/her authorized agent. I understand that storage of contact information, including but not limited to names, telephone numbers, and email addresses in the TTC's request database may constitute a public record which may be subject to disclosure under the California Public Records Act, Government Code Section 6250.
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field