Form Rev 63 0001 - Application For Property Tax Exemption
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Application for Property Tax
Date:
Exemption
Comment:
Chapter 84.36 RCW
Instructions are located at the end of this form.
This section is for Department of Revenue’s use only
Fee Due:
Paid
Assessment Year:
Registration Number:
-
County #:
Section 1 - Applicant Information
Name:
(Name of the Church or Nonprofit Organization conducting the exempt activity and claiming the exemption.)
Mailing Address:
Street or PO Box
City
State
Zip
Contact Person:
Title:
Phone:
Email:
Has your organization been issued a Tax Registration Number or Unified Business Identifier by the State of Washington?
Yes
No
Unknown If yes, what is your TRN/UBI number?
-
Does your organization currently have a property tax exemption on any property in Washington?
Yes
No
Unknown If yes, what is your registration number?
-
Is your organization currently exempt from federal income tax under 501(c)?
Yes
No
Section 2 – Property Information
I am claiming exemption for: (Check all boxes that apply)
Real Property Tax (building & land)
Owned
Leased
Personal Property Tax (furnishings & equipment)
Owned
Leased
Leasehold Excise Tax (lease of government owned property)
Leased
(Government Owner/Lessor)
Site/Location Address:
Street Address
City
County
State
Zip
Property ID/Parcel
#:
Please use a separate application if parcels are not contiguous, adjacent, or part of a larger campus/site
1. Describe the activity conducted on or using this property and state the name of the occupant if different than applicant.
2. Was this property exempt to the previous owner or lessee?
Yes
No
Unknown
3. Does your organization allow other individuals or organizations to rent/use this property?
Yes
No
4. Does this property include a
parsonage
convent or
caretaker residence?
Yes
No
5. Are any buildings planned or under construction?
Yes
No
If yes, what is/was the start date?
What is the estimated completion date?
To ask about the availability of this publication in an alternate format, please call 1-800-647-7706. Teletype (TTY) users may use the Washington
Relay Service by calling 711. For tax assistance, call (360) 534-1400.
REV 63 0001 (6/2/15)
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