Addition To Exemption Application Humanitarian Service Provider

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Addition to Exemption
KSA 79-201 Ninth
Page 1 of 2
Applicant Name: ________________________
Docket No. _____________________________
Addition to Exemption Application
Humanitarian Service Provider
K.S.A. 79-201 Ninth
1.
Name of the community service organization.
______________________________________________________________________________
2.
Name and address of related organizations.
______________________________________________________________________________
3.
Are the directors compensated for the service as directors?
_____No
_____Yes
If yes, indicate the nature of the compensation.
______________________________________________________________________________
______________________________________________________________________________
4.
Do any of the members, officers, or directors have a financial interest in the property?
_____No
_____Yes
5.
What service or services are being offered to the community?
______________________________________________________________________________
______________________________________________________________________________
6.
Is there a demonstrated need for these services to the general public? How did you determine that
the services were needed in your community or area?
(a)
Why is this service needed, i.e., how will the general public benefit from the service?
(b)
Do the services provided meet this need?
(c)
Do you provide services to the general public or to a specific class of beneficiaries?
(d)
Are there commercial businesses or other organizations in the community that offer
services similar to those at issue? If so, list.
(e)
Will the service have a positive influence on the community? Please explain.
(f)
Submit a letter provided by community leaders, elected officials, or state agencies
evidencing that there is a community need for this service.
Revised 7/14

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