Mark Lewis Tax Grievance Service
Application and Authorization Form
 


[Download Application]

 

Please read the following conditions before filling out the application at the bottom of this page:


CONTRACT CONDITIONS
I  agree to the following conditions:

1. The Mark Lewis Tax Grievance Service, Inc. is not a government agency and is not affiliated with any government agency.

2. The Mark Lewis Tax Grievance Service, Inc. will furnish me with my property’s full valuation, based on my total assessment upon request. I alone determined that my property had a lesser value than my township is claiming.

3. I am fully aware of the fact that I myself may receive a tax assessment reduction through my own efforts, but I elect to employ The Mark Lewis Tax Grievance Service, Inc.

4. I understand that The Mark Lewis Tax Grievance Service, Inc. will make reasonable efforts to fully communicate an offer of settlement made to them by the township in course of a tax assessment review proceeding, other than a hearing or a trial, with respect to the affected parcel of real estate. I am aware that in many cases offers are made where it is imperative to make a decision immediately. I fully authorize The Mark Lewis Tax Grievance Service, Inc. and their agents to fully negotiate a settlement for me.

5. At anytime, within three (3) days, after entering into this contract, I have the complete right to cancel. Cancellation must be in writing and sent to the Mark Lewis Tax Grievance Service, Inc., via certified mail in that three (3) day period.

6. “Only: 1. a person named in the records of Suffolk County Clerk as a homeowner; or 2. that person's authorized agent; or 3. a person who has contracted to buy the home; or 4. the estate of a deceased homeowner, is eligible under law to receive a tax assessment reduction and a property tax refund. If you are not in any of these four categories, you will not be able to receive a property tax refund and you should not sign this agreement.”

7. If the home is sold prior to finalization of the grievance, the seller is responsible for fees incurred unless the new homeowner assumes responsibility of the grievance by signing our authorization form.

FEES

I fully understand that there are NO (NONE) fees or disbursements to be paid by me prior to The Mark Lewis Tax Grievance Service, Inc., filing my grievance. If the grievance is denied at grievance level and small claims level, The Mark Lewis Tax Grievance Service, Inc., is responsible for all court fees and disbursements and I will not be obligated to pay anything. When the assessment is reduced as a result of the process initiated by The Mark Lewis Tax Grievance Service, Inc., I agree to pay the following:

A: FEES: I have engaged The Mark Lewis Tax Grievance Service, Inc., 1685 Middle Country Rd., Centereach, NY 11720, as sole and exclusive agent, to obtain a reduction of the assessed value of my property. I agree to pay them a DISCOUNTED FEE equal to 50% of the reduction prior to exemptions for my 2012/2013 property taxes. The discounted fee will apply if I pay within 30 days of the postmark on the envelope that contained the invoice and a copy of the official decision reporting the reduction of my property's assessed value. The tax reduction amount is calculated by multiplying the amount that the property's total assessed value is reduced by the tax rate for the 2012/2013 tax bill for the tax district in which the property is located prior to exemptions. The full UNDISCOUNTED FEE of 75% of the 2012/2013 property tax reduction will be due if full payment is not made or a written agreement from the Mark Lewis Tax Grievance Service, Inc. for a payment schedule is not obtained within 30 days of postmark.

B: I agree to pay a $75 appraisal fee (upon winning grievance only). This fee will be waived if I supply a certified appraisal dated no more than 1 year prior to grievance day. I will supply this appraisal to The Mark Lewis Tax Grievance Service, Inc. no later than May 1, 2012.

C: If I fail to pay the above fees within 30 days of notification, I agree to pay reasonable attorney fees to The Mark Lewis Tax Grievance Service, Inc. I am aware that interest, at a rate of 1.5% per month on any unpaid balance will be added to my bill 31 days from the postmark on the envelope containing the invoice.

D. All fees are payable within 30 days of The Mark Lewis Tax Grievance Service, Inc. receipt of the official notification of reduction, or fees may be deducted from any county refund checks at The Mark Lewis Tax Grievance Service, Inc. sole discretion. On any reduction obtained in small claims court, the $30 court fee will be applied to the amount due to The Mark Lewis Tax Grievance Service, Inc. This agreement is not assignable except by prior written agreement between the parties.

E. I agree that the Mark Lewis Tax Grievance Service, Inc. is the sole agent: If a reduction occurs for the 2010/2011 tax year and/or the 2011/2012 tax year and/or the 2012/2013 tax year through the efforts of anyone other than Mark Lewis Tax Grievance Service, I agree to pay the Mark Lewis Tax Grievance Service the sum of $350 for their time, efforts and expenses within 30 days.

Any part of this contract that is deemed unlawful does not void the remaining parts of this contract


Application

Fill out to the best of your ability, if you are not sure of an answer leave it blank.

*indicates a required field
 

Homeowner Name*:
SS#:
   
Email Address*
Can we contact you Via Email? Yes No
   
Address of Home
Street*:
City*:
State*:
Zip*:
Home Phone #*:
Business Phone #:
Cell Phone #:
Inc. Village (if any)
   
Mailing Address of Homeowner (if different)
Street:
City:
State:
Zip:
School District:
Home Style (Colonial, Ranch, Cape, Split):
# of Stories:
Age of Home:
Lot Size of Property:
Approx. Sq. Foot of Living Area:
No. of Rooms not including Bathrooms:
No. of Bedrooms:*
No. of Baths:*
Waterfront?* Yes No
Waterview?* Yes No
Central A/C:* Yes No
Garage:* Yes No Attached Detached
No. of Cars*
Inground Pool?* Yes No
Number of Kitchens:*
Fireplace?* Yes No
Basement*: Yes No
Basement Type: Full Part
Basement Finish: Finished Unfinished
Date Home Was Purchased:
Amount of Purchase:
Did you purchase from a relative? Yes No
Was this purchase a foreclosure/distress/estate/short sale? Yes No
If yes please specify:
 

 
Do you live in the home?* Yes No
   
Property Recently Offered for Sale?* Yes No
Date Listed:
Asking Price:
   
What do you believe the property and home are worth? (Market Value):
Nearest Crossroad to Property:
Any Negative Aspects of your home that might effect its value? Yes No
If "yes" above, explain: