BAA-application25MV

Motor Vehicle Board of Assessment Appeals 
 
 
 
 
 
 
 
Application to Appeal 
 
Board of Assessment Appeals has 
Date 
Time 
Place 
Scheduled an appointment as follows:  
Appeal Summary 
 
 
 
Assessments 
Grand List 
Board of Assessment Appeals 
Motor Vehicle 
  
 
  
 
Total 
  
 
  
 
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. 
 
Email Address 
Grand List of: 2025 
List No: 
Property Description: 
Make 
 
Year 
 
Model 
 
Vin 
Reason for Appeal: 
Appellant’s estimate of value: 
 
 
(Attach documentation of value. If applicable) 
Pursuant to P.A. 95-283 of the State of 
Connecticut, an application to appeal an assessment 
must be filed: 
On or before September 2, 2026 
All sections must be completed.  
Applications may be sent to: 
 
Board of Assessment Appeals 
15 Rope Ferry Road 
Waterford, CT 06385 
Signature of Property owner or duly authorized agent (attach evidence of authorization) 
Date