Claim For Exemption Form

Download a blank fillable Claim For Exemption Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Claim For Exemption Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

REAL PROPERTY ASSESSMENT DIVISION
Parcel ID (Tax Map Key)
DEPARTMENT OF BUDGET
AND FISCAL SERVICES
CITY AND COUNTY OF HONOLULU
Above enter 12-digit Parcel ID
Parcel information can be found at
For example: 210630150000
Phone: (808) 768-3799
CLAIM FOR EXEMPTION
Alternate Energy Improvements - Revised Ordinances of Honolulu (“ROH”) Sec. 8-10.15
Name of Applicant
Title of Applicant
Telephone
Property Address
City
State
Zip
Name of Business/Organization
Mailing Address
City
State
Zip
Email Address
Total land area of parcel: ________________
Sq.Ft.
Acre(s)
Ownership:
Fee Simple
Leasehold
Current use(s) of property: ______________________________________ (i.e., Industrial, Commercial, Residential, etc.)
Briefly describe the “alternate energy improvements” that qualify this property for an exemption under ROH, Section 8-10.15:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
The cost of improvements actually used toward this alternate energy exemption claim: $ ____________________
The City and County of Honolulu’s Department of Planning and Permitting information:
Permit #: __________________ Permit Value: $____________________
REQUIRED ATTACHMENTS (must be submitted with claim)
Copy of recorded lease or recorded rental agreement (for leased or rented property only)
Plot plan illustrating the location of alternate energy improvements on the parcel
Documentation verifying total cost, date installed, and life expectancy of energy-producing or energy-conserving improvement
CERTIFICATION
I declare, under penalty of law, that all statements in this exemption claim are true and correct to the best of my
knowledge. I acknowledge this claim for exemption, once allowed, shall continue for a period of 25 years. I understand
that any misrepresentation of facts will be grounds for disallowance and penalty.
________________________________________
_________________________________
____________________
Applicant’s Signature
Print Name
Date
Complete the claim form and deliver or mail (post office cancellation mark) with supporting documentation, on or before
September 30, preceding the tax year for which you are claiming the exemption to either office:
Real Property Assessment Division
Real Property Assessment Division
842 Bethel Street, Basement
1000 Uluohia Street #206
Honolulu, HI 96813
Kapolei, HI 96707
This claim cannot be filed by facsimile transmission or via email. For a receipted copy, submit with a self addressed stamped envelope.
FOR OFFICIAL USE ONLY
Approved
Disapproved
_______ Initials
For Tax Year: _______________
Received By: _________________________________________ Date Received (post office cancellation mark): _________________ Appraiser No. ____________
Building # ______ Building Exemption: ____________ Building %__________ Building # ______ Building Exemption: ____________ Building %____________
Attachments:
Recorded lease or rental agreement
Plot plan
Improvement documentation
BFS-RP-P-5D (Rev. 02/16)
Telephone: (808) 768-3799
Page 1 of 2

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Boe-268-b - Exemption For Property Used By A Free Public Library Or Free Museum Claim For Exemption From Property Taxes Form Boe-268-b - Exemption For Property Used By A Free Public Library Or Free Museum Claim For Exemption From Property Taxes Financial
Form Boe-260-a - Certificate And Affidavit For Exemption Of Certain Aircraft Claim For Exemption From Property Taxes Under Section 2 Of Article Xiii Of The Constitution Of The State Of California And Section 217.1 Of The Revenue And Taxation Code Form Boe-260-a - Certificate And Affidavit For Exemption Of Certain Aircraft Claim For Exemption From Property Taxes Under Section 2 Of Article Xiii Of The Constitution Of The State Of California And Section 217.1 Of The Revenue And Taxation Code Financial
Form Boe-262-ah - Church Exemption - Claim For Exemption From Property Taxes - 2011 Form Boe-262-ah - Church Exemption - Claim For Exemption From Property Taxes - 2011 Financial
Form Boe-268-a - Claim For Exemption From Property Taxes (public School Exemption) - California Form Boe-268-a - Claim For Exemption From Property Taxes (public School Exemption) - California Financial
Form Mvu-33 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred To A Disabled Person - Massachusetts Department Of Revenue Form Mvu-33 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred To A Disabled Person - Massachusetts Department Of Revenue Financial
Form Mvu-21 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred By Contest, Drawing Or Raffle Form Mvu-21 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred By Contest, Drawing Or Raffle Financial
Form Mvu-29 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Purchased Outside Of Massachusetts - 1999 Form Mvu-29 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Purchased Outside Of Massachusetts - 1999 Financial
Form G-27a - Motor Vehicle Use Tax Certification - Affidavit In Support Of A Claim For Exemption From Use Tax For A Motor Vehicle Transferred As A Gift Form G-27a - Motor Vehicle Use Tax Certification - Affidavit In Support Of A Claim For Exemption From Use Tax For A Motor Vehicle Transferred As A Gift Financial
Form Mvu-25 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred By A Business Entity Form Mvu-25 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred By A Business Entity Financial
Form Mvu-33 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred To A Disabled Person - 2011 Form Mvu-33 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred To A Disabled Person - 2011 Financial

Related Categories

Parent category: Financial
Download
Go
Page of 2