Form Fp 161 - Exempt Property Use Report printable pdf download

Form Fp 161 - Exempt Property Use Report

GOVERNMENT OF THE DISTRICT OF COLUMBIA

FFICE OF

AX AND

EVENUE

EAL

ROPERTY

DMINISTRATION,

, . .

TREET

, D.C. 200

ASHINGTON

EXEMPT PROPERTY USE REPORT (FORM FP 161)

Square: _______

Suffix:

_______

Lot:

_______

Parcel:

_______

Calendar Year: ________

Please complete the following Exempt Property Use Report using the enclosed instructions.

1. Name and mailing address of exempt institution or organization:

Name: _____________________________________________________________________________

Address: ___________________________________________________________________________

City:

State: ___________________Zip: _________________

2. Location of property (premise address): ________________________________________________

___________________________________________________________________________________

3. Type of institution or organization (e.g. religious, educational, charitable, etc.): _________________

4. State, in detail, how the exempt property, identified by the square and lot or parcel and lot, was used during the

calendar year indicated above. Include both buildings and grounds:

5. Was any building, structure, or grounds, or any portion thereof used by the institution or organization, or the

occupant thereof, to secure direct, indirect, or in-kind rent or income during the year? O Yes O No

Form Fp 161 - Exempt Property Use Report