Form Av-10 - Application For Property Tax Exemption
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1Form AV–10
YEAR ___________
Web
10–02
APPLICATION FOR PROPERTY TAX EXEMPTION
County ____________________ Town or City ____________________
Owner
Address
(Street or Route)
(Town)
(State)
(Zip Code)
1.
Location of Property
INSTRUCTIONS
Under the provisions of G. S. 105–282.1 every owner of property claiming exemption or exclusion from property taxes must demonstrate that the property
meets the statutory requirements for exemption or classification. Claims for exemption or exclusion must be filed with the Assessor of the county in
which the property is located. (see reverse side) Claims for exemption should include all land and improvements and personal property situated thereon
and complete information regarding its use.
The undersigned owner or authorized representative hereby petitions for exemption of the following described property:
2. Give complete description of property:
Land:
Improvements:
Personal Property:
3. List and explain the purposes for which the property is used:
Land:
Improvements:
Personal Property:
4.
If any organization other than the owner uses the property, give the name of the organization, full particulars regarding its use of the
property and the amount of any income received for such use.
5. Give your estimate of the true value in money of the property:
Land:
Improvements:
Personal Property:
6. Upon what uses or purposes do you base this claim for exemption?
Charitable (
);
Religious (
);
Educational
(
);
Literary (
);
Scientific (
);
Other
7. Give the specific statutory authority upon which this property is claimed as exempt:
(Full texts of all exemption and classification statutes are available at the office of the county Assessor.)
AFFIRMATION
Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief, the statements and information in this
application are true and correct, and are made for the purpose of exempting the property herein described from taxation.
20
Signature of owner or authorized representative
APPROVED
YES
NO
Title
Telephone No.
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Parent category: Financial