Clear form
                                                      Before The Utah State Tax Commission
                                                                                                                             TC-738
                                                      Petition for Redetermination                                           Rev. 11/15

If you need help with this form, contact the Tax Appeals Unit at 801-297-3900 or email taxappeals@utah.gov

Petitioner (print or type)                                              Representative Information (if applicable)
Taxpayer/owner/company name:
                                                                          If completed by the petitioner: I authorize the person named below as my 
                                                                          representative to discuss and share information concerning this appeal with the Tax 
Doing business as (DBA):                                                  Commission. ________ (initial)

Mailing address:                                                          If completed by the representative: As representative, I have Power of Attorney 
                                                                          (POA) to file this appeal. The POA is included with this petition.  ________ (initial)
                                                                          Representative name:

Daytime phone:                Other phone:                                Mailing address:

Email:

Social Security number/FEIN/Tax Commission account number:                Daytime phone:                     Other phone:

Social Security number of spouse (if filing jointly):                     Email:

Tax Type and Primary Issue (check all that apply)
  This appeal involves:
   Individual income tax     Corporate franchise tax           Sales and use tax            Motor vehicle
   Penalty/Interest          Refund request                    Assessment                   Other (specify): ___________
  This appeal involves an assessment, decision or action by the following Tax Commission Division:
  Auditing Division        Taxpayer Services Division       Motor Vehicle Division      Other (specify): ___________
  Tax year, audit period or period under audit is:____________
  If this appeal is due to a decision, letter, assessment or notice issued by a division in the Tax Commission, a copy of the division’s 
  letter or notice needs to be attached to this petition. Note below the date of the division’s action, as well as the name and title of the 
  division representative who took action.
  Date of action:_______ Division representative’s name and title:______________________________

 Request for Relief
  Describe the basis for your appeal and the relief you seek from the Tax Commission (attach additional pages if necessary):

Requirements and Signatures (check all boxes and sign)
  I have included with this petition the letter, assessment or notice issued by the Tax Commission division that was the cause of this 
      appeal. I noted above the date of action and the name of the division representative who took action.
  I understand I must provide information supporting my position to the Tax Commission Appeals Unit ten (10) business days before 
      the scheduled hearing. I further understand if my information is not provided as directed, my information might not be accepted at 
      the hearing.
  I acknowledge if I have designated a representative, all notices and communications regarding my appeal will go to my representative.
  ___________________________  _________________________ __________
  Name of taxpayer/authorized individual/representative (PRINT) Signature                                                Date
Submitting Petition to Tax Appeals
 Best way: Email taxappeals@utah.gov
 By mail: Tax Appeals Unit, Utah State Tax Commission, 210 North 1950 West, Salt Lake City, UT 84134
 By fax: 801-297-3919