Instructions For Form Ed-50 Notice Of Property Tax And Certification Of Intent To Impose A Tax - 2001-2002 Page 3

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Form ED-50 Sample
2001–2002
Notice of Property Tax and
FORM
ED-50
Certification of Intent to Impose a Tax, Fee,
Assessment or Charge on Property for Education Districts
To assessor of ______________________ County
Sample
• File no later than JULY 15.
Check here if this is
an amended form.
• Be sure to read instructions in the 2001–2002 Notice of Property Tax Levy Forms and Instructions booklet.
Sample School District
The __________________________ has the responsibility and authority to place the following property tax, fee, charge or assessment
District Name
Sample
on the tax roll of ______________________ County. The property tax, fee, charge or assessment is categorized as stated by this form.
County Name
P.O. Box 2222
Example
OR
97111
Mailing Address of District
City
State
ZIP
Ann Example
Superintendent
(541) 488-8001
6/30/01
Contact Person
Title
Daytime Telephone
Date
PART I: TOTAL PROPERTY TAX LEVY
Subject to
Education Limits
May certify a rate or
amount. Carry rate out
Rate –or– Dollar Amount
four decimal places.
4.7000
1. Permanent rate limit tax (per $1000)
1
Amounts and rates
.05
2. Local option operating tax
2
entered in boxes 1–5
Excluded from
must be the same as
3. Local option capital project tax
3
Measure 5 Limits
what is in the resolution.
Amount of Levy
4. Levy for “Gap Bonds”
4
$
5,790
5. Levy for bonded indebtedness not subject to Measure 5 or Measure 50
5
Must be a dollar amount.
Certification—Check one box.
X
The tax rate or levy amounts certified in Part I are within the tax rate or levy amounts approved by the budget committee.
Must check box
The tax rate or levy amounts certified in Part I were changed by the governing body and republished as required in ORS 294.435.
indicating the tax is
PART II: RATE LIMIT CERTIFICATION
within the rate or amount
approved or box
4.7000
6. Permanent rate limit in dollars and cents per $1,000
6
indicating budget was
republished.
7. Date received voter approval for rate limit if new district
7
8. Estimated permanent rate limit for newly merged/consolidated district
8
PART III: SCHEDULE OF LOCAL OPTION TAXES — Enter all local option taxes on this schedule. If there are more than three taxes,
attach a sheet showing the information for each.
Purpose
Date voters approved
First year
Final year
Total tax amount –or– rate
(operating, capital project, or mixed)
local option ballot measure
levied
to be levied
authorized per year by voters
Operating
May 16, 2000
2000
2004
$
.05
Must be completed if you
have local option tax.
150-504-057 (Rev. 12-00)
File with your assessor no later than JULY 15, unless granted an extension in writing.
11

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