Board of Assessment Appeals Form - 23GL

Board of Assessment Appeals 
Applications may be sent to: 
Board of Assessment Appeals 
15 Rope Ferry Road 
Waterford, CT 06385  
Pursuant to P.A.95-283, of the State of Connecticut, an 
application to appeal an assessment must be filed: 
on or before February 20, 2024.
All sections must be completed.  The board 
of Assessment Appeals does not have to give a hearing 
date to incomplete applications.  Please print or type. 
Application to Appeal
 
 
 
 
 
 
Appeal Summary_____________________________________________________________________ 
Assessments 
Grand List 
Board of Assessment Appeals 
Land 
____________________________ 
____________________________ 
 Building 
____________________________ 
 ____________________________ 
 Miscellaneous 
____________________________  
 ____________________________  
 Total 
____________________________  
 ____________________________ 
     Motor Vehicle 
____________________________  
 ____________________________ 
 Personal Property 
____________________________  
 ____________________________ 
Board of Assessment Appeals: (signatures) 
X___________________________________X__________________________ 
X___________________________________Date of Board’s Decision:______________ 
Property Owner: 
Name 
Address 
City/State/Zip 
Appellant: 
Name 
Address 
City/State/Zip 
Correspondence & Contact: 
Name 
Address 
City/State/Zip 
Phone No. 
Grand List of: 2023 GL 
List No.: 
Property Description: 
No. & Street 
Map/Block/Lot 
(if available) 
Property Type 
__Residential __Commercial 
__Industrial  __Motor Vehicle  __Personal Property 
Reason for Appeal: 
Appellant’s estimate of value: 
(attach documentation of value, if applicable) 
Signature of Property owner or duly authorized agent(attach evidence of authorization) 
Date 
Board of Assessment Appeals has: 
Date 
Time 
Place 
Scheduled an appointment as follows: