There is not a template for that.
I often refer to this page [link] as a rough guide on citations for a wide variety of record types.
There is a 'complete' (and complicated) example given on the Evidence Explained site of citing a tax roll:
Madison County, Mississippi, Tax Rolls, 1829–1842, unpaginated entries arranged chronologically, all years read for entries relating to Vick, Green, and Anders; consulted as “Mississippi, State Archives, Various Records, 1820–1951,” FamilySearch (https://familysearch.org/search/collection/1919687 : accessed 4 September 2014), path: Browse > Madison > County tax rolls; citing MDAH boxes 3717 and 3445.