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Form Rp-485-F - Application For Real Property Tax Exemption For Branch Bank In Banking Development District - 1999 Page 2

RP-485-f (1/99)

6. Use of property.

a. Describe the property or portion of the property used for branch bank purposes.

b. Describe any other use or uses of the property.

7. Attach proof that branch bank is located within designated banking development district.

Certification

I, ____________________________________ hereby certify that the information on this application and

any accompanying pages constitutes a true statement of facts.

____________________________________

______________________

Signature

Date

FOR ASSESSOR’S USE

1. Date application filed: _________________

2. Applicable taxable status date: __________________

3. Action on application:

Approved

Disapproved

4. Assessed valuation of parcel in the first year of exemption:

5. Increase in total assessed valuation in first year of exemption: $

6. Amount of exemption in first year:

Percent

Amount

County

City/Town

________

$ ______________________

Village

________

$ ______________________

School District

________

$ ______________________

______________________________________________

_________________________

Assessor’s signature

Date

Form Rp-485-F - Application For Real Property Tax Exemption For Branch Bank In Banking Development District - 1999 Page 2