Form Rp-485-F - Application For Real Property Tax Exemption For Branch Bank In Banking Development District Page 2

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RP-485-f (1/99)
2
6. Use of property.
a. Describe the property or portion of the property used for branch bank purposes.
b. Describe any other use or uses of the property.
7. Attach proof that branch bank is located within designated banking development district.
Certification
I, ____________________________________ hereby certify that the information on this application and
any accompanying pages constitutes a true statement of facts.
____________________________________
______________________
Signature
Date
Clear Form
FOR ASSESSOR’S USE
1. Date application filed: _________________
2. Applicable taxable status date: __________________
3. Action on application:
Approved
Disapproved
4. Assessed valuation of parcel in the first year of exemption:
$
5. Increase in total assessed valuation in first year of exemption: $
6. Amount of exemption in first year:
Percent
Amount
County
$
City/Town
________
$ ______________________
Village
________
$ ______________________
School District
________
$ ______________________
______________________________________________
_________________________
Assessor’s signature
Date

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