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Harris County Appraisal District T RrEQUES4 TO SPLIT OUT OR CCDIll(9�INE �
Information & Assistance Division; REAL PROPERTY A�.C®LDVv P S1
P.O. Hox 920975 I
Itouston`fX�1729M975 Acct.No.: 9 Next Tax Year:
Instructions
You may use this form to ask the Harris Couhly Appr2aAlstrict to split out property that has been sold fireman existing
parcel, or to request that two or more parcels be combined Into one. After completing the form mail it back to the Harris
County Appraisal District at the address above. If you are delivering this form briny it to our Information & Assistance
Division located at 13013 Northarest Fwy. if you have any questions, please call (713) 957-7890• E
- Please Print or Typo all Information. .
Ifyou need additional space for listing owners, legal descriptions, or account numbers, plooso attach additional pages
fiN plit parcel into 2 or more now parcels ❑ Acreage Correction CI Pick up Improvements
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0�=to combination of parcels, fist accounts to be combined
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copy OF DEED MUST DE PROVIDED, INCLUDING THE SURVEYOR'S METES AND BOUNDS DESCRIPTIONGtS!>i^ THE
PROPERTY(IES) INVOLVED. YOU MUST ALSO PROVIDE EITHER A SURVEY MAP OR A MAP DRAWN T ALF� o
SHOWING THE DESIRED CHANGES & WHERE THE IMPROVEMENTS (BUILDINGS) Go. <
Owner's Namd }J t-- ; _
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0.0 Mailing Address T
"t State 21p Cara
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Daytime Telephone (area code and number) Evening Telephone (area code and number)
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Legal Description(d) Legal Description (2) �OO
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Property Location Address Property Location Address
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city State Zip Code Guy State Zip Code
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I am owner of the grope
_Q records torofloottheinf
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a E Signature
Printed Name
described above and request the Harris County Appraisal District to correct its
nation listed above.
_ Date r
_.. Title rn�+u�c
Any person who makes a false entry rrpod iha faregoittg recort��,rr�� Jye su6nj t to one of the fallowing penalties;
1j confinement In Jal! for a term up to 1 year or a fine not fo oxr,��S;DOa�t7�oth such fine and tmprlsonment,•
2J confinement of up to 1 yearin a communlfy correetlonal faculty 3)ltnprfsorunont of not more than 10 years and/or
a fine of not more than $10,000 or both such fine and imprjs;ohtient as set forth in Section 37.10, Penal Code.