1.
Who is the legal owner of the property? (Include all owners of an interest in the property and describe their
interest.)
2.
When was the property acquired?
3.
(a).
How was the property acquired?
(b).
Provide a copy of the deed and a copy of the property record card (if available).
(c).
Provide a picture of the property and buildings: “Exterior and Interior”
4.
(a).
Has this organization previously been granted any tax exemption by the Commonwealth of Kentucky?
Yes
No (If yes, describe.)
(b).
Has this organization previously been granted any tax exemption under Section 501 of the Internal Revenue
Code?
Yes
No (If yes, attach a copy of the authorization letter.)
5.
Attach a statement detailing compensation, if any, to the following organization members:
A.
Offi cers
B.
Directors
C.
Trustees
D.
Five Highest Paid Professional Service Employees
E.
Five Highest Paid Employees
6.
List the names and salaries of any family members serving in any capacity in the organization.
7.
List types of employees performing activities of the organization and their qualifi cations. Indicate which, if any, of
these persons receive compensation for their activities.
8.
(a).
Is any course of instruction offered on the property?
Yes
No
(If yes, describe the
instruction.)
(b).
Is it open to the public?
Yes
No
Is there any charge or fee required for
attendance?
Yes
No (If yes, how is the money utilized by the organization?)
9.
Attach a resume of past activities in which the organization has participated in, present activities and future
plans of the organization.
10.
Describe the current use of the property.
11. Does or will this organization limit its benefi ts, services or products to specifi c classes of persons?
Yes
No (If yes, explain.)