Form 150-310-013 - Application For Water Association Exemption printable pdf download

Application for Water Association Exemption

ORS 307.210

Assessor’s Use Only

• File with the county assessor on or before April 1 preceding the tax year. The tax

Date received

year begins July 1.

Approved

• No application is required if all property was exempt the previous year and

ownership or use of the property remains unchanged.

Denied

Property Subject to This Request (attach a separate sheet if needed to describe property)

Complete name of water association (Print)

Assessor’s account number (as shown on the property tax statement)

Is this a change of address?

Physical address of property

Yes

Representative Who Can Furnish Necessary Information

Name (Print)

Telephone number

( )

Mailing address

City

State

ZIP code

Yes

1. Is the association incorporated? .....................................................................................................

2. Does the association operate on a nonprofit basis? ......................................................................

3. Does everyone who receives water service share in the cost of construction, maintenance,

and operation of the system, and in the division of any surplus or reserve funds that

accumulate when the surplus or reserve is not needed for construction or maintenance

of the system? .................................................................................................................................

4. Does the association have any income or investment not related to obtaining, storing,

conveying, or distributing water? If yes, attach an explanation ......................................................

5. Is everyone who receives water service a member of the organization? .......................................

6a. Is voting restricted to one vote per member, or .............................................................................

6b. In proportion to each member’s patronage, as provided by the bylaws? ......................................

7. Is providing domestic or irrigation water services to members the primary purpose of the

association? ....................................................................................................................................

8. How many members does the association have? ..........................................................................

___________

9. How many members are commercial users of the water? .............................................................

___________

10. How much water was used by members of the association during the last calendar year?

Indicate gallons or cubic feet ..........................................................................................................

___________

11. How much of the water (as indicated in #9 above) was used by commercial users in

commercial establishments? Indicate gallons or cubic feet ...........................................................

___________

12. What assessments, dues, or annual charges (other than water service charges)

20______ $__________

were made against members within the last three years? ..........................................

20______ $__________

150-310-013 (Rev. 04-11)

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Form 150-310-013 - Application For Water Association Exemption

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