Application For Real And Personal Property Tax Exemption Form - Oregon

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APPLICATION FOR REAL AND PERSONAL PROPERTY TAX EXEMPTION
For Specified Institutions and Organizations
As provided by Oregon Revised Statute 307.162
Account # ________________
• File with your county assessor on or before April 1.
See ORS 307.162 and OAR 150-307.162 on the back of this form.
Name of Organization/Owner
FOR ASSESSOR’S USE ONLY
Date Received
Late Filing Fee
Mailing Address
Telephone Number
$
Exemption
City
State
ZIP Code
Approved
Denied
begins
By
in tax year 20
A property tax exemption is requested under the following Oregon Revised Statute (mark one box):
307.115 Nonprofit corporation public parks*
307.145 Child care facilities, schools, student housing*
307.118 Wastewater and sewage treatment facilities*
307.147 Senior services centers*
307.130 Literary, benevolent, charitable, scientific
307.150 Burial grounds, cemeteries, crematory associations*
institutions, volunteer fire departments*
307.160 Public libraries*
307.136 Fraternal organizations*
307.580 Industry apprenticeship or training trust*
307.140 Religious organizations*
307.818 Public beach access
*Note: Please attach a current copy of your organization’s articles of incorporation and by-laws.
PROPERTY DESCRIPTION
Account Number (as shown on your property tax statement)
Name of Property Owner
Physical Address (street address, city)
List all real and personal property for which an exemption is claimed. Attach list of personal property.
PROPERTY USE
The purpose of this organization is:
The property is used for the following purpose:
Example: church services, offices, sales, etc.
Does the property include a parking area?
Yes
No
What is the fee for using the parking area?
Is the property used by others?
Yes
No
If yes, explain and identify the area that is used by others.
LATE FEE
If this form is filed after April 1, the late filing fee must accompany the form. The late filing fee is one-tenth of one percent of the real market
value, or $200.00, whichever is greater. A late fee is attached:
Yes
No
DECLARATION
I declare under the penalties for false swearing [ORS 305.990(4)] that I have examined this document (including any accompanying
attachments and statements) and to the best of my knowledge, it is true, correct, and complete.
Name (please print or type)
Title
Signature
Date
X
150-310-088 (Rev. 10-00) Web

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