Affidavit Affirming Vehicle Ownership And Use - Request For Exemption From Personal Property Taxes On Vehicles Owned And Used By Churches For Charitable, Religious, And Educational Purposes

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COUNTY OF FAIRFAX
DEPARTMENT OF TAX ADMINISTRATION
PERSONAL PROPERTY AND BUSINESS LICENSE DIVISION
12000 Government Center Parkway, Suite 223
Fairfax, Virginia 22035-0029
VOICE: (703) 222-8234 FAX: (703) 324-3505
WEB PAGE HOME:
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FFIDAVIT
FFIRMING
EHICLE
WNERSHIP
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EQUEST
OR
XEMPTION
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ERSONAL
ROPERTY
AXES ON
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EHICLES
WNED AND
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HURCHES FOR
HARITABLE
ELIGIOUS
AND
DUCATIONAL
URPOSES
Instructions:
This form is for use by churches, religious associations, or denominations, or their duly designated ministers,
ecclesiastical officers, or trustees. Please supply all information requested. Failure to supply information may
result in a delay in processing this request. Please attach a copy of each vehicle’s most recent registration/title, and
if applicable, most recent personal property tax bill. Please mail all information to the address given above,
Attention: Personal Property Division -- Exemption Request.
Ministers or duly designated officers of a church: In addition to the information requested above, please also
attach a letter prepared by an officer of your church, other than yourself, affirming your appointment as minister
and the date you were called to serve the church’s congregation.
Note: To be exempt, a vehicle must be registered solely in the name of the church, or duly designated minister.
The following vehicles do not qualify for exemption: (1) Vehicles owned jointly with a spouse, individual, or other
organization, and (2) Vehicles not used predominantly for exempt purposes.
Church Name:
____________________________________________________________________________
Church Address:
____________________________________________________________________________
__________________________________________Phone #___________________________
Vehicle Owner’s
Name:
__________________________________________Title:_____________________________
Owner’s Address:
____________________________________________________________________________
__________________________________________Phone #___________________________
The vehicles(s) listed below are registered solely to the above cited church, religious association, denomination, or
duly designated ecclesiastical officer or trustee and are used predominately on a non-profit basis for charitable,
religious, or educational purposes as provided by Section 58.1-3617 of the Code of Virginia.
Make
Year
Vehicle Identification Number
Date Purchased
_____________ _______________
_______________________________________
______________
_____________ _______________
_______________________________________
______________
Declaration -
Signature: __________________________________________
I declare that the statements and figures
Printed Name: ______________________________________
herein given are true, full, and correct
to the best of my knowledge and belief.
Title: _______________________Date: __________________
Vehicle Affidavit Revised 7/1/00

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