Form Otc 900xm - Application For Five-Year Ad Valorem Tax Exemption For Oklahoma Manufacturing Or Research & Development Facilities Page 6

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AFFIDAVIT
STATE OF OKLAHOMA
COUNTY
I,
, being first duly sworn, according to law, depose and say: that I am the
of
_______________________________________________ Company; that as such I am acquainted and know the accompanying
statements, as shown by the exhibits, schedules and property listings herein to be true, correct and complete, as reflected by the
records and books of account of the Company; and that all information requested herein has been fully and correctly given.
__________________________________________________________________________
Applicant Signature*
Subscribed and sworn to before me this
day of
,
.
Seal
__________________________________________________________________________
Notary Public Signature
My Commission Expires:
___________________________
*If other than a Company officer BT129 Power of Attorney form must be attached.
Assessor Use Only
The assessment percentages for this county are as follows:
Real Property: _____
%
Personal Property: _____
%
Located in school district:
_________________________
Ad Valorem Reference Number:
____________________________________
Signed:
______________________________________________
, County Assessor
Date:_______________________________
-4-

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