Form 402 - Improvements On Leased Land Assessment Application
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Improvements on Leased Land
FORM
TO BE FILED WITH
THE COUNTY
Assessment Application
402
ASSESSOR
NAME AND ADDRESS OF OWNER OF THE LAND
NAME AND ADDRESS OF OWNER OF THE IMPROVEMENTS
Name
Name
Street or Other Mailing Address
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
Legal Description and County
Description of the Improvements
I request that the improvements described on this form be assessed and taxed separately to the owner of the improvements.
sign
Signature of Owner of the Land
Date
here
Date
Signature of Owner of the Improvements
FOR COUNTY ASSESSOR’S USE ONLY
COMMENTS:
Date Received
Signature of County Assessor
INSTRUCTIONS
Improvements on leased land are real property and may be assessed and taxed separately to the owner of
the improvements.
WHO MAY FILE. Any person, corporation, or organization who is the owner of the land, or who is the owner of the
improvements, may file Form 402 to seek separate assessment for taxation of the real property improvements. If this form is
not filed, the value of the improvements will continue to be assessed to the owner of the real property parcel.
WHEN AND WHERE TO FILE. Before March 1, either the owner of the land or the owner of the improvements may file
the Form 402 with the county assessor of the county where the improvements are located.
APPEAL PROCEDURES. When the Form 402 is filed by the owner of the leased land, notice will be given by the county
assessor to the owner of the improvements at the address listed on the form. If the owner of the improvements disagrees with
the request for separate assessment of the improvement, an appeal may be filed with the county board of equalization within
30 days of the date of the county assessor’s notice.
SIGNATURE. This form must be signed by either the owner of the land or the owner of the improvements.
RETAIN A COPY OF THIS APPLICATION FOR YOUR RECORDS.
Nebraska Department of Revenue, Property Assessment Division
Authorized by Neb. Rev. Stat. § 77-1376
96-254-2006 Rev. 6-2012
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