Application For Exemption From Erie County Real Property Taxes Form Page 2
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212. Are any of your funds used or distributed for any monetary gain or profit to the members? Yes □
No □
Or for any purpose other than those set forth herein? _____________________________________________
13. Is any portion of the property not used by the applicant? Yes □
No □
If so, briefly describe the unused portion ______________________________________________________
_______________________________________________________________________________________
14. If the applicant is a church, describe any portion of the property not actually used in worship services. (For
example: parking lots, minister’s residence, or vacant land.) _____________________________________
_______________________________________________________________________________________
15. Is the property, or any part thereof used at any time for any other than the purposes set forth herein?
Yes□
No□ If so, describe such use _______________________________________________________
_______________________________________________________________________________________
16. Is any part of the property used for recreation of the members? Yes□ No □
If so, describe the portion so used and the extent of the recreational use. _____________________________
_______________________________________________________________________________________
17. Is any portion of the property occupied, rented or leased to anyone other than the applicant? Yes□
No□
If so, please describe particulars and provide copies of the signed leases or agreements.
___________________
______________________________________________________________________________________
18. Attach two (2) copies of any supplementary information you wish the Board to consider as part of your
application. Please provide a copy of your State Sales & Use Tax Certificate if you are applying for
Exemption as a non-profit 501(c)3 organization
.
19. In what manner does this institution (a) advance a charitable purpose; (b) donate or render gratuitously a
substantial portion of its services; (c) benefit a substantial and indefinite class of persons who are legitimate
subjects of charity; (d) relieve the government of some of its burden; and (e) operate entirely free from the
profit motive? (Please attach appropriate documentation in support of these statements.)
NOTICE: This application must be accompanied by a non-refundable Filing Fee (make checks payable to County of Erie) for
processing before it is considered a valid Exemption Application, per County Council Ordinance No. 157-2007. The filing fee is
$50.00 per parcel, or where several parcels comprise a property as a whole, $50.00 for the main parcel plus $10.00 for each
additional parcel that comprises the whole. If you are eligible for accommodation under the AMERICANS WITH DISABILITIES
ACT please contact us immediately so that arrangements may be made.
I certify that the above statements are true to the best of my knowledge.
____________________________________________________________
Please Complete and Return to:
Signature
Date
Erie County Board of Appeals
Erie County Court House
____________________________________________________________
140 West Sixth St., Room 104
Signature
Date
Erie PA 16501-1097
Rev. 01/08
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