Nevada State Board of Equalization

form 5105 SBE form 5105 SBE agent authorization Page 1 Last Revised 12-15-2017 Nevada State Board of Equalization agent authorization form If you have questions about this form or the appeal process, please call: (775) 684-2160. Email completed form to: or Fax (775) 684-2020 Mail: State Board of Equalization , 1550 College Parkway, Carson City, NV, 89706 Please Print or Type: Part A. PROPERTY OWNER AND CONTACT INFORMATION OF PERSON GRANTING AUTHORITY TO agent NAME OF PROPERTY OWNER AS IT APPEARS ON THE TAX ROLL: NAME OF PERSON GRANTING AUTHORITY TO agent (IF DIFFERENT THAN PROPERTY OWNER LISTED IN PART A): TITLE MAILING ADDRESS OF PETITIONER (STREET ADDRESS OR BOX) EMAIL ADDRESS: CITY State ZIP CODE DAYTIME PHONE ALTERNATE PHONE FAX NUMBER Part B.

Form 5105SBE. Form 5105SBE Agent Authorization Page 1 Last Revised 12-15-2017 . Nevada State Board of Equalization . Agent Authorization Form . If you have questions about this form or the appeal process, please call: (775) 6842160.

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