Renewal Form Not-For-Profit Or Full Exemption (Page 2 of 2) in pdf

Renewal Form Not-For-Profit Or Full Exemption Page 2

Renewal Form - Not For Profit - Full Exemption

Page 2

SECTION THREE

PART 1.

Check the one statement below that best describes the current occupant of the property.

The property is completely occupied by the organization that owns it.

The property is partly or completely occupied by an affiliated subsidiary of the organization that owns it.

The property is completely or partly leased to a not-for-profit organization that is not related to the

organization that owns it.

The property is not occupied. However, it is the intention of the owner organization to occupy the

property in the future.

Other (please describe):

_________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________

PART 2:

Check all of the categories listed below that describe the current use of the property.

Residential - Check one:

Parsonage

Dormitory housing

Staff housing

Other. Specify:

___________________________________________________________________________

Religious Services

Educational

Administrative offices for the organization that owns the property or a tenant

Medical/Therapeutic Services

Other (please specify):

___________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________

SECTION FOUR

SIGN AND DATE BELOW TO CERTIFY THE ACCURACY OF ALL INFORMATION YOU PROVIDED IN THIS FORM.

I certify that all information contained in this application is true and correct to the best of my knowledge and belief. I un-

derstand that willful making of any false statement of material fact herein will subject me to the provisions of law relevant

to the making and filing of false instruments and will render this application null and void.

SIGNATURE

TITLE

DATE

Renewal Form Not-For-Profit Or Full Exemption Page 2