IN THE SUPERIOR COURT OF ARIZONA IN THE ARIZONA TAX COURT COVERSHEET ______________________________________ Case Number (Clerk Use Only) For Clerk's Use Only If you wish to file a Small Claims Tax case your case must qualify by you checking at least one of the three boxes below and checking that you want to proceed as a Small Claims tax case. If your case does not qualify it will be filed as a Record Tax case. The property in dispute is your primary residence. The cash value of all real and personal property in dispute is $2,000,000 or less. This is not a property tax case and the amount of taxes, interest, and penalties in dispute is $5,000 or less. If you have checked one of the above boxes, would you like to proceed as a Small Claims Tax case? Yes No, I wish my case to proceed as a Record Tax case. Please type or print the following information (Rule 10, Rules of Practice, Arizona Tax Court). TAXPAYER OR PLAINTIFF'S NAME TAXPAYER OR PLAINTIFF'S ADDRESS Names of Additional Taxpayers or Plaintiffs Type or print the name and either state bar number or TXR number of the taxpayer or plaintiff's representative. Authority for taxpayer or plaintiff's representative to act as a representative: (Check One) Attorney Licensed in Arizona DEFENDANT'S NAME Prior Tax Court Approval Yes Is this a property tax case? No Staff Use Only: (TX ­ 400/401) (ST ­ 460/461) (TX ­ 430/437) (ST ­ 490/497) Information entered on this form is true and correct to best of my belief and knowledge, under penalty of law. Date: Signature: NOTICE This "Cover Sheet" must accompany new tax actions filed with the Maricopa County Superior Court. Please do not include this form with cases that have already been filed, as it can only be processed when filing new complaints and petitions. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED TXSC10f ­ 111313 American LegalNet, Inc. www.FormsWorkFlow.com