HomeMy WebLinkAbout200619Harris County Appraisal District
Information & Assistance Division
P.O. Box 920975
Houston TX 77292-0975
REQUEST TO SPLIT OUT OR COMBINE
REAL PROPERTY ACCOUNT(S)
Acct. No.:0Q
Next Tax Year: �Z/j
Instructions '
You may use this form to ask the Harris County Appraisal District to split cut property that has been sold from an 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 bring it to our Information & Assistance
Division located at 13013 Northwest Fwy. If you have any questions, please call (713) 957-7800.
Please Print or Type all Information.
If you need additional space for listing owners, legal descriptions, or account numbers, please attach additional pages
4- 4- ?1 Split parcel into 2 or more new parcels ❑ Acreage Correction ElPick up improvements
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Q. Cr ❑ If a combination of parcels, list accounts to be combine
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COPY OF DEED MUST BE PROVIDED, INCLUDING THE SURVEYOR'S METES AND BOUNDS DESCRIPTION OF THE
PROPERTY(IES) INVOLVED. YOU MUST ALSO PROVIDE EITHER A SURVEY MAP OR A MAP DRAWN TO SCALE
SHOWING THE DESIRED CHANGES & WHERE THE IMPROVEMENTS (BUILDINGS) GO.
Owner's Name
CL Mailing Address
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43,h,.c f J
C City State
3 � , Zip Code
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S t� r) \0,-nc
Daytime Telephone (area code and number) Evening Telephone (area code and number)
Legal Description(1) Legal Description (2)
9LK _ 3;� Lo r 1 L. ll t3 D
a O j
a � Property Lo ation Address Property Location Address
7 75 7 L o- 9 7S-7
City State Zip Code City State Zip Code
G I am owner of the property described above and request the Harris County Appraisal District to correct its
records to reflect the information listed above.
E Signature �s Date (�a�-d�C)
�t7Y1 t�
Q Printed Name — L°- Title C —e-I-L oerK1!
Any person who makes a false entry upon the foregoing record may be subject to one of the following penalties;
1) confinement in jail for a term up to 1 year or a fine not to exceed $3,000 or both such fine and imprisonment;
2) confinement of up to 1 year in a community correctional facility; 3) imprisonment of not more than 10 years and/or
a fine of not more than $10,000 or both such fine and imprisonment as set forth in Section 37.10, Penal Code.