Form Dte 24 - Tax Incentive Program - Application For Real Property Tax Exemption And Remission Page 2

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DTE 24
Rev. 4/05
Page 2
a)
1. Parcel number(s).(If more than
four, continue on an attached
b)
sheet.) All parcels must be in
c)
the same school district.
d)
2. School district where located
3. Street address or location of property
4. a) Title to this property is in the name of
b) Address of owner
5. Date title was acquired
6. If title holder is different from applicant, please explain
7. Under what section(s) of the Ohio Revised Code is exemption sought?
 §725.02
 §1728.10
 §5709.40(B)
 §5709.40(C)
 §5709.41
  §5709.62
 §5709.63
 §5709.71
 §5709.73(B)
 §5709.73(C)
  §5709.78(A)
 §5709.78(B)
 §5709.88
  Other incentive program, specify R.C. section
8. Explain terms and details of incentive (real property included, percentage exempted, number of years, etc.).
9. a) Attach a copy of the resolution or ordinance of the subdivision granting the incentive and/or the applicant’s incentive
agreement with the subdivision.
b) Attach a copy of school district approval (if required).
10. If this application requests exemption under a tax increment fi nancing provision (see special instructions), please indicate
whether the application is being fi led.
 By the property owner
 By the political subdivision without owner consent
  By the political subdivision with owner consent (attach copies of DTE form 24P)
I declare under penalty of perjury that I have examined this application and, to the best of my knowledge and belief,
it is true, correct and complete.
Applicant or representative signature
Print name and title
Address
City
State
ZIP code
Telephone number
Date

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