DTE 23V
Rev. 11/13
Reset Form
Current Tax Year 20
Veterans’ and Fraternal Organization Tax Exemption Renewal Application
Applicant name
Name
Notices concerning
Name (if different from applicant)
this application
should be sent to
Address
City
State
ZIP code
Phone number
1. Parcel number(s)
a)
(if more than four, continue
on an attached sheet.)
b)
c)
d)
2. Street address or location of property
3. Gross income earned from rentals in the preceding year, as stated on IRS form 990 (if applicable):
20
$
I declare under penalties of perjury that this statement has been examined by me and to the best of my knowledge and belief
is a true, correct and complete statement.
Signature of applicant or representative
Date
Print name and title
Auditor Instructions
Applicant Instructions
Fill in the name, address,
1. For the property listed above to remain on the tax-exempt list for the current year,
parcel numbers and the
the property owner must fi le this renewal application with the county auditor to report
appropriate tax years at
the gross income earned from the property in the preceding year.
the top and on line 3 for
2. Complete this form by fi lling in the gross income amount on line 3 and signing
property exempted under
the application. Then return it to the county auditor by Oct. 1 of the year of
Ohio Revised Code (R.C.)
application.
5709.17. Mail to the property
owner in suffi cient time to be
3. If this form is not returned to the county auditor, the auditor will restore the above
returned by Oct. 1.
property to the taxable list. See R.C. 5713.08(A) and 5713.082.