Form 50-128 - Application For Miscellaneous Property Tax Exemptions - 2010 Page 3

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50-128 (Rev. 11-05/10) - Page 3
[11-23-A]
Schedule A: Description of real property
• Complete one Schedule A form for EACH parcel qualified for exemption.
• Attach all completed schedules to your application for exemption.
Name of owner
Legal description of property
Appraisal district account number (Optional):
Describe the primary use of this property
__________________________________________________________________________________________________________
Yes
No
1. Is this property used exclusively for charitable purposes? .................................................................................................
Yes
No
2. Is this property held for gain, rented or used with a view to profit? ...................................................................................
Yes
No
3. Is this property the organization’s state headquarters? ......................................................................................................
Yes
No
4. Is this property reasonably necessary for operation of the association/organization? .......................................................
5. Is this property located in a medical center area where the organization
has donated land to the state for hospital or medical school?...........................................................................................
Yes
No
If “YES,” is the medical center development complete? ....................................................................................................
Yes
No
Yes
No
6. Is the property currently under active construction or physical preparation? .....................................................................
A. If under construction, when will construction be completed? (date) _______________________**
B. If under physical preparation, check which activity the organization has done.
(Check all that apply.)
Architectural work
Land clearing activities
Engineering work
Site improvement work
Soil testing
Environmental or land use study
7. Is the incomplete improvement designed and intended to be used by a qualified person for a purpose
described by Section 11.23 (a)-(e), (g), or (i)-(k)? ................................................................................................................
Yes
No
8. Is the land on which the incomplete improvement is located necessary for the use of the improvement for a
Yes
No
purpose named in Question 7 above? ................................................................................................................................
List all other individuals and organizations that used this property in the past year, and give the requested information for each.
NAME
DATES USED
ACTIVITY
RENT PAID, IF ANY
Continue on additional sheets as needed.
**An incomplete improvement exempted for the three years preceding the 2003 tax year is entitled to exemption for the 2003 tax year regardless of whether
the property owner applies for the exemption for the 2003 tax year if the property otherwise qualifi es. The chief appraiser may require the property owner
to fi le an application to confi rm the owner’s qualifi cation for exemption for the 2003 tax year. An exemption for an incomplete improvement is for fi ve years.
Effective January 1, 2006, the exemption will revert back to three years.

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