Attestation for Personal Property Adjustment

Owner Information

Phone Number

Account Number (Not Applicable for Leased Vehicles)

Vehicle Information

Year

Make

Model

Estimated mileage on January 1, 2024

Plate Number

Item Number (Last 6 characters of the Item Number on your bill OR last 6 characters of your VIN#)

Assessment Type

New or Previous Assessment Appeal

New

Vehicle Condition Appeal Process

Comments

To appeal, please select which category best describes your vehicle on January 1, 2024.

Mileage will be checked for all vehicles. Please rate the condition of your vehicle.

Condition Categories

This vehicle has high mileage only, no damage.

Minor Damage - The vehicle may have small paint scratches, or door dings. vehicle will need minimal reconditioning to be made ready for resale.

Average Condition - Paint, body and wheel surfaces have moderate imperfections and an average finish which can be improved with restorative repair. The interior reflects some soiling and wear in relation to vehicle age. Pictures required – no more than five (5) PDF pictures.

Rough Condition - Significant defects requiring repairs to restore to a reasonable condition; paint, body and wheel surfaces have considerable damage to their finish, small to medium size dents, frame damage, rust, interior reflects above average wear, heavily soiled /permanent imperfections on the headliner, carpet, and upholstery; vehicle will need substantial reconditioning and repair to be made ready for resale; some existing damage may be difficult to restore. Pictures required – no more than five (5) PDF pictures.

Average - Please attach up to 5 images (jpg or gif) of the associated damage.

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Rough - Please attach up to 5 images (jpg or gif) of the associated damage.

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Comments - Please provide a description of the cosmetic damage.

I attest that I am the owner/co-owner of this vehicle and that the information contained on this form is true, correct and complete to the best of my knowledge.