Form Dr-504cs - Ad Valorem Tax Exemption Application Charter School Facilities
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1AD VALOREM TAX EXEMPTION APPLICATION
DR-504CS
N. 12/00
CHARTER SCHOOL FACILITIES
Section 196.1983, Florida Statutes
This form must be signed and returned on or before March 1.
For use by charter schools or owners of facilities used to house a charter school.
Applicant name
Charter school name
Address
Address
Phone
Parcel ID
Legal description
Percentage and description of property used by charter school
%
As of January 1 of this year, 20
, the property listed above was used to house a charter school whose
charter has been approved by the charter school's sponsor and the governing board pursuant to section
228.056(9), F.S.
I understand that the property appraiser may require supplemental and additional information, other than the
application, and I am willing to comply with any reasonable request to furnish this information.
TO BE COMPLETED BY LANDLORD
I hereby certify that the above charter school has been provided an affidavit certifying that lease payments
made by the school will be reduced to the extent of the exemption received. The full amount of the benefit
derived from the exemption
has been
will be disclosed to the charter school on
(date)
and the amount will be credited through an
annual
monthly credit to the charter school's lease
payments.
Under penalties of perjury, I declare that I have read the foregoing application and that the facts stated in it are
true. If prepared by someone other than the applicant, this declaration is based on all the information of which
he or she has knowledge.
Signature
Title
Date
WHO MUST FILE?
Any charter school who owns property used as a charter school facility or any owner of
property leased and used as a charter school facility.
WHERE TO FILE?
The application return must be filed with the county property appraiser in the respective
county where the property is located.
WHEN TO FILE?
Application or return must be filed each year on or before March 1.
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