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2. 2021 911 Fee Appeals are due by December 31st, 2021. Please be aware that if you submit this form after that date, we cannot guarantee your appeal will be reviewed.

4. Property Information
   Please submit a separate appeal form for each individual parcel.
6. Property Owner Name*
7. Property PIDN*
9. Property/Parcel Street Address*
10. City*
14. Reason for Appeal*
    Please summarize the reason(s) you believe this property should be exempt from the 911 fee.
16. Contact Information
18. First Name*
19. Last Name*
21. Email Address
22. Phone Number*
24. Address*
26. City*
27. State*
28. Zip Code*
30. Are you the property owner?*

    1. Yes
    2. No
31. If not the owner, please specify reason you are filing this appeal instead of property owner.
35. Agreement & Submission
37. By checking the "I agree" box below, you agree and acknowledge that: 1) your application will be submitted and considered without your handwritten signature; 2) that you are consenting to an electronic signature, which is the same as your handwritten signature for the purposes of validity, enforceability and admissibility; 3) that in lieu of an electronic signature, you may contact Kenton County Office of the Treasurer for a printable version of the application and submit it using your handwritten signature using either USPS or another delivery or courier service; 4), that your submitted application will be made available to you upon written request subject to applicable record retention guidelines.*

    1. I agree
39. All forms must be submitted by December 31st.
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field