PR
                  Department of                                                                                      Rev. 12/21
                  Taxation
   hio
                                        Petition for Reassessment
        Complete all applicable blanks and type or print in ink. See instructions for completing this form.
A. General information
Taxpayer name(s)                                                            Assessment serial # 
                                                                            Date of assessment 
Address                                                                     Account #   
                                                                            Tax period(s) 
City                                    State          ZIP                  Disputed amount(s) 
Tax type (e.g., personal income, sales) 
Daytime phone #                                    Federal  emp.     I.D. # (last four digits only) XX-XXX- __ __ __ __
E-mail address                                     If personal income tax, include last four digits of Social Security no.
Fax #                                              SSN – Self XXX-XX-__ __ __ __    Spouse – XXX-XX-__ __ __ __

B. Please note: The tax commissioner may correct the assessment by issuing a “corrected assessment” pursuant to Ohio
Revised Code 5703.60. This process is not available for property tax and some public utility tax matters. This streamlined
procedure may result in a more timely resolution of this matter.

C.    Check this box if you do NOT     D. Select one of the following boxes:          E.  Check this box if this petition 
        want the “corrected assessment”     Please decide this matter based                  is in response to a “corrected 
        procedure used.                         upon the information submitted.               assessment.”  
                                                No hearing is requested.
                                            I request a hearing by telephone. 
                                            I request a personal appearance 
                                                hearing.             
                                        (Hearings are held in Columbus, Ohio.)

F. Basis for filing this petition for reassessment (petition must list specific issues/objections):

 Basis for petition continued on attached. This is page one of       pages. 

G. Person responsible for the filing of this petition. I declare under penalty of perjury that I’m the taxpayer or that I’m an
authorized agent of the taxpayer having knowledge of the relevant facts in this matter to file this petition for reassessment. 
Signature                                                                          Date 
Name                                    Title                                      Tel. # 

H. Contact person (if different from the person above responsible for filing this petition for reassessment)
Name                                                                        Title  
Address                                                                     Fax #
                                                                            Daytime tel. # 
City                                    State          ZIP                  E-mail address
I. Mail this form to:                   For pass-through entity (PTE) or 
For excise or energy taxes, including   fiduciary income taxes:                               For all other taxes:
motor fuel or public utility:           Ohio Department of Taxation                           Ohio Department of Taxation 
Ohio Department of Taxation             Pass-Through Entity & Fiduciary                       Administrative Review Section 
Excise & Energy Tax Division            Income Tax Division                                   P.O. Box 1090 
P.O. Box 530                            P.O. Box 2476                                         Columbus, OH  43216-1090 
Columbus, OH 43216-0530                 Columbus, OH 43216-2476
For Department Use Only

                                                                                                                                            Rev. 12/21
                            Instructions for Completing Petition for Reassessment
n  This  is  a  generic  form  that  may  be  used  to  file  a  Petition  for D. Select a Box  (If a corrected assessment is issued, THERE WILL 
   Reassessment for any tax. For purposes of these instructions,                   BE NO HEARING, even if you requested one.) 
   all  assessment  notices  are  covered  by  the  term  “assessment,”        n   No hearing: All of your information will be carefully reviewed and 
   regardless of their technical title.                                            considered, but you will not have to participate in a hearing. 
n  IMPORTANT: Because different taxes have different filing deadlines,         n   Hearing by telephone: This is an informal discussion to gather facts 
   you may safely file this form  NO LATER THAN 60 DAYS from the                   and listen to the taxpayer’s (or representative’s) legal arguments. 
   date found on the assessment         and you will be timely regardless          You may submit information. Please number your pages and retain a 
   of the type of tax assessed.                                                    duplicate for yourself so that specific documentation can be reviewed 
n  Laws relating to particular types of assessments are located in Title           and discussed during the hearing. You may use a conference call to 
   57 of the Ohio Revised Code. You are responsible for complying with             include your representative or anyone else you choose. 
   all of the requirements of the law. (The on-line link to the Revised        n   Personal appearance hearing:       This is an informal face-to-face 
   Code is available at tax.ohio.gov. Go to the “Tax Professionals”                meeting centered on gathering facts and listening to the taxpayer’s 
   tab, then to the heading “Laws/Rules/Rulings.”)                                 (or representative’s) legal arguments. This is also the taxpayer’s 
                                                                                   opportunity to present any documentation for review and discussion.
Section-by-Section Instructions
A.  General Information                                                        E. Petition in Response to a “Corrected Assessment”
n  Most of the information that you need to complete this section can          n   If you have already received a “corrected assessment” and you are 
   be found on the assessment. Please use it as a reference.                       filing this petition because you disagree with the adjusted amount 
n  Daytime phone:  Please provide the number where you can be                      on the “corrected assessment,” CHECK THE BOX.
   reached during business hours. 
n  E-mail address: Providing your e-mail address will allow us to              F.  Basis for Filing this Petition for Reassessment
   communicate with you efficiently and discreetly.                            n   Please list all of the reasons that you think the Ohio Department 
n  Assessment  serial  number:          This  number  is  listed  on  the          of Taxation erred when it issued the assessment or the corrected 
   assessment. It is not applicable for personal property, dealer                  assessment. You must be specific with your objections. However, 
   intangibles or public utility tax assessments.                                  you are free to present your case in the manner of your choice. 
n  Date  of  assessment:    The  date  found  on  the  assessment                  You may make legal arguments. You may cite specific sections of 
   document.                                                                       the Ohio Revised Code or the Ohio Administrative Code. You may 
n  Tax period(s): List the periods or the tax year(s) assessed.                    reference and attach specific court or Board of Tax Appeals cases. 
n  Disputed amount:     The portion of the assessment that you are                 You may attach photographs or include any other documentation. 
   protesting. Usually, this amount does not need to be paid before                You are not limited. You may attach additional pages, but please 
   this petition is  filed. However, there are exceptions. For example,            CHECK THE BOX and list the total.
   when only the penalty or interest is being protested in the corporate 
   franchise tax or personal income tax, payment of tax and interest           G. Person Responsible for Filing this Petition
   (but not penalty) is required.                                              n   Name/title: This is the individual vouching for the accuracy of the 
                                                                                   information presented. This person should be familiar with all of the 
B. Corrected Assessment     is NOT available for property and public               facts and issues related to this matter. This may be the individual 
   utility assessments (except in R.C. 5727.26 and R.C. 5727.89).                  petitioner, an employee or owner of the business, or the person 
n  What is a “corrected assessment”? According to R.C. 5703.60,                    designated as the representative. Whoever is responsible for filing 
   when a petition for reassessment has been properly filed, the Tax               this request must provide their signature, name, title, date and phone 
   Commissioner may respond by issuing a “corrected assessment.”                   number. 
   This is a more streamlined response to the petition than a final 
   determination and it may both simplify and expedite resolution of the       H. Contact Person    (Information required ONLY if different from the 
   matter. The Notice of Corrected Assessment does not contain the                 “Person Responsible for Filing this Petition.”)
   legal analysis of the tax commissioner. Only a final determination          n   This may be the individual petitioner, an employee or owner of the 
   (not a corrected assessment) can be appealed to the Board of Tax                business, or a separate person chosen to be the representative. A  
   Appeals or Ohio courts.                                                          representative does not need to be an attorney or an accountant, 
n  What if the taxpayer disagrees with the “corrected assessment”?                 but the petitioner must authorize them. 
   If a corrected assessment is issued and the taxpayer disagrees with         n   If the contact person is the taxpayer’s representative, the taxpayer 
   the result, the taxpayer still has the option of filing a new petition          needs to complete form TBOR 1 and return it along with this petition. 
   for reassessment protesting the “corrected assessment.” This same               Form TBOR 1 authorizes the contact person to represent the claimant 
   form is used to file a petition in response to a corrected assessment.          and allows the Ohio Department of Taxation to talk to this person. (An 
   In response to this new petition, the Tax Commissioner will issue a             on-line link is available at tax.ohio.gov  . Go to the “Tax Professionals” 
   final determination.                                                            tab, then to the heading “Taxpayer Representation.”)
n  What if the taxpayer fails to file a new petition for reassessment 
   after receiving a “corrected assessment”?      According to R.C.            I.  Mail This Form To: 
   5703.60, the issuance of a corrected assessment nullifies the original      n   Different taxes must be mailed to different addresses. If in doubt use 
   petition for reassessment and the original petition is not subject to           the address provided for “all other taxes.”
   further administrative review or appeal. Therefore, the corrected           n   The petition may be hand delivered to:
   assessment becomes final.                                                       – 4485 Northland Ridge Blvd., Columbus, OH 43229

C. In Order to Request That the “Corrected  Assessment” 
   Procedure NOT Be Used CHECK THE BOX
n  If this box is checked, a final determination will be issued and the 
   streamlined procedure will not be used.