Form Idr 54-019 - Application For Historic Property Rehabilitation Tax Exemption
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1Application for Historic Property
IOWA
Rehabilitation Tax Exemption
Iowa Code Section 427.16
This application must be filed or mailed to your city or county assessor by February 1 of assessment year.
It must be postmarked no later than February 1.
Iowa assessors’ addresses can be found at the Iowa State Association of Assessors Web site.
Applicant Contact Information
PLEASE PRINT
Name: ________________________________________________________
Phone Number:___________________ eMail: ________________________
Number __________________
Legal Description: _________________________________________________________________________________
_______________________________________________________________________________________________
Address of Property: _______________________________________________________________________________
Titleholder or contract buyer: ________________________________________________________________________
Address, If different than above: ______________________________________________________________________
Existing property use:
Ag
Res
Com
Ind
Additional property tax relief or financial assistance
Allowed:
No _________ Yes ________ (Attach documentation , if yes.)
Completion Date: ____________________________ Cost: __________________
Attach any plans or blueprints. Include documents previously filed and approved by State Historical Office.
The owners of the above property do hereby make application for the Historic Property Rehabilitation Tax Exemption in
accordance with the provisions of Iowa Code section 427.16.
I declare under penalty of perjury that I have reviewed this claim and to the best of my knowledge and belief, it is true,
correct, and complete.
_______________
(______)______________
__________________________________
Date
Telephone Number
Claimant’s Signature
To Be Completed By The Assessor
Application received: _____________________
Priority assigned:
1
2
3
4
Dist. _________ Map ___________ Parcel __________
I hereby certify that the above property is eligible to receive the tax exemption as provided
by Iowa Code section 427.16.
_________________________________
Assessor
Annual report of exemptions to be sent to County Auditor by July 1 each year.
IDR 54-019 (03/06/12)
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Parent category: Financial