Form 50-121 - Application For Dredge Disposal Site Exemption
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150-121 (Rev. 8-03/7)
[11.29 Rule 9.415]
YEAR
APPLICATION FOR DREDGE DISPOSAL SITE EXEMPTION
Appraisal district name
Phone (area code and number)
Address
This application covers property you owned on January 1 of this year. You must file the completed application between January
1 and April 30 of this year. Be sure to attach any additional document requested. If the chief appraiser grants the exemption, you
do not have to reapply annually. However, you must reapply if the chief appraiser requires you to do so or if you want the exemp-
tion to apply to property not listed in this application. You must notify the chief appraiser in writing if and when your right to this
exemption ends. Return the completed form to the address above.
Owner’s name
Step 1:
Owner’s name
Present mailing address
and address
City, town or post office, state, ZIP code
Phone (area code and number)
Individual
Association
Corporation
Nonprofit Corporation
Owner is a(n): (please check)
Name of person preparing application
Driver’s License, Personal I.D. Certificate, or
Title
Social Security Number*:
Legal description:
Step 2:
Describe
the property
Appraisal district account number (Optional):
Is there a recorded easement dedicating this property for use as a disposal site for
materials dredged from the main channel of the Gulf Intracoastal Waterway under
Yes
No
federal or state supervision? ...................................................................................................................
Yes
No
Is the property actively used as a dredge disposal site? .......................................................................
Attach a copy of the recorded document dedicating the property.
Step 3:
By signing this application, you certify that this information is true and correct to the best of your knowledge and belief.
Sign the
application
Signature
Date
On behalf of (name of organization)
Title
If you make a false statement on this application, you could be found guilty of a Class A misdemeanor or a
state jail felony under Texas Penal Code Section 37.10.
* You are required to give us this information on this form, in order to perform tax related functions for this office. Section 11.43 of the Tax
Code authorizes this office to request this information to determine tax compliance. The chief appraiser is required to keep the information
confidential and not open to public inspection, except to appraisal office employees who appraise property and as authorized by Section
11.48(b), Tax Code.
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