Form 50-117 - Application For Religious Organization Property Tax Exemption Page 4

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P r o p e r t y T a x

A p p l i c a t i o n f o r R e l i g i o u s O r g a n i z a t i o n P r o p e r t y T a x E x e m p t i o n

Form 50-117

Schedule BR: Personal Property Used at Actual Place of Religious Worship

or Clergy Residence

• List only that personal property which is reasonably necessary for worship at actual place of religious worship or for use at a residence for clergy.

____________________________________________________________________________________________________

Name of Property Owner*

____________________________________________________________________________________________________

Legal Description (if known)

____________________________________________________________________________________________________

Appraisal District Account Number (if known)

* If owner is state or political subdivision of the state, attach copy of lease agreement.

Type of Property

Location of Property

Continue on additional sheets as needed.

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Page 4 • 50-117 • 08-11/12