Form Av-10v - Application For Motor Vehicle Exemption

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4
AV-10V
Web
PRINT
CLEAR
6-11
Year
Application for Motor Vehicle Exemption
County
City or Town
Under the provisions of G. S. 105–330.3 every owner of property claiming exemption or exclusion from property taxes must
demonstrate that the property meets the statuatory requirements for exemption or classification. Claims for exemption or
exclusion of personal property must be filed with the assessor of the county in which property is located.
Name of Owner
Address
Give complete description of property:
Tag Number
Date of Purchase
Make/Model
Year
Vin Number
Upon what use or purpose do you base this claim for exemption?
Charitable
Religious
Educational
Other
AFFIRMATION – Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief, the statements and
information on this application are true and correct, and are made for the purpose of exempting the property herein described from
taxation.
Signature of owner or authorized representative
Phone Number
Title
Date
APPROVED
YES
NO

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