Clear Form
Application for
For Assessor’s Use Only
Property Tax Exemption
Date received
on Student Housing
Account no.
Late filing fee
As provided by ORS 307.471
$
Exemption
Approved
Denied
Instructions
begins
1. File application with the county assessor on or before April 1. See ORS 307.471.
By ____________________
in tax year 20 ______ – ______
2. The “Certification of Housing Use” below is to be signed by an officer of the college
or university attended by the majority of your student occupants.
3. Prepare three copies. Distribute one copy to the county assessor; one copy to the college or university and retain one copy for your records.
4. Attach additional sheets if necessary for property description.
Filed with the ____________________________________ County Assessor for tax year beginning July 1, _______.
Name of organization
Telephone number
(
)
State
ZIP code
Mailing address
City
Assessor’s account number (as shown on your tax statement)
Physical address of property
I request an exemption for the above-name property pursuant to ORS 307.471.
1. The property is owned by a nonprofit corporation incorporated as a:
Student Housing Corporation ________________
(Complete Section B)
Fraternity __________________________________
Section
Sorority ___________________________________
A
Cooperative Housing Organization ____________
(Complete Section C)
Pertains
Associated Alumni Corporation ______________
to all
Note: Attach a copy of the “Articles of Incorporation” if:
applicants.
a. This is your first application, or
b. A copy was filed with a prior application and changes have occurred since then.
2. Is the housing rented exclusively to students of an educational institution which offers at
least a two-year program acceptable for full credit towards a baccalaureate degree? .........................................
Yes
No
1. Are housing accommodations rented upon a nondiscriminatory basis, without regard to race, creed,
color, or national origin? ..........................................................................................................................................
Yes
No
Section
2. Have legally enforceable arrangements been made to convey the corporation’s interest in the above-
B
described property to the educational institution or institutions which serve the students housed in such
property upon final payment of the mortgage indebtedness incurred in connection with the construction
or acquisition thereof? ............................................................................................................................................
Yes
No
3. Are the rents, charges, developments, costs, and methods of operation regulated by federal or state law? .......
Yes
No
1. Are the housing accommodations, not occupied by members of the organization, open to occupancy by
Section
students not members of or affiliated with the organization on a nondiscriminatory basis, without regard to
C
race, creed, color, or national origin?......................................................................................................................
Yes
No
2. Is the incorporation organized exclusively for the purpose of owning property housing the Fraternity, Sorority,
or Cooperative Housing Organization and for providing related financial and operational support? .....................
Yes
No
I declare under the penalties for false swearing (ORS 305.990(4)) that I have examined this document and to the best of my knowl-
Applicant’s
edge it is true, correct, and complete.
Declaration
X
Signature of officer
Title
Date
I hereby certify that the above-described property is being used for housing by students during the current school year, the majority
of which students are attending this institution.
Certification
of Housing
Name of college or university ________________________________________________________________________________
Use
X
Signature of college or university officer
Date
See other side for applicable law.
150-310-078 (Rev. 01-11)