MIAMI -DADE COUNTY VALUE ADJUSTMENT BOARD EVIDENCE LIST AND SUMMARY FOR ALL PARTIES Agenda # _________________ Hearing Date ______________ Room _______ Owner/Agent Name ___________________________________________ Agent Code ____ Taxpayer/Owner Exchange of Information Response delivery method (Please choose only one) Email address ______________________________________________________ Fax Fax Number ( ) ________-___________ st Pick Up Front Counter 111 N.W. 1 St., Suite 710 US Mail Address ___________________________________________________ Documentary Evidence and Exhibits (Please provide a copy of all documents) Document Source or Author Description/ Type # of Date Pages Summary of Testimony Owner/Agent (Witness List and Additional Testimony on next page) ________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Please submit to: Miami-Dade County Property Appraisal Department Using one of the following: Email To PAVABSUBMISSION@miamidade.gov or Fax To (305) 375-5164 or Mail To P.O. Box 12840 Miami, Fl 33101-2840 or st Drop Off At 111 N.W. 1 Street, Suite 710, Miami, Fl CLK/CT 895 REV.11/03 1 >>>> 2 Agenda # _________________ Hearing Date ______________ Room _______ Witness Name _________________________________ Phone__________________________________ Testimony: ________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Witness Name _________________________________ Phone _________________________________ Testimony: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Witness Name _________________________________ Phone _________________________________ Testimony: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Additional Testimony: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Please submit to: Miami-Dade County Property Appraisal Department Using one of the following: Email To PAVABSUBMISSION@miamidade.gov or Fax To (305) 375-5164 or Mail To P.O. Box 12840 Miami, Fl 33101-2840 or st Drop Off At 111 N.W. 1 Street, Suite 710, Miami, Fl CLK/CT 895 REV.11/03 2