Application Form For Property Tax Exemption - Tennessee State Board Of Equalization (Page 2 of 2) in pdf

11. When did your organization receive the property? _______________________________________________________

12. What was the purchase price of the property?____________________________________________________________

13. What is the appraised value of the land?________________________________________________________________

14. What is the appraised value of structures? ______________________________________________________________

15. What is the value of the personal property?______________________________________________________________

16. If under construction, what is the estimated value of the completed building? ___________________________________

17. For real property, describe all structures located on the parcel: ______________________________________________

___________________________________________________________________________________________________

18. List all current uses/activities and state how often each use/activity occurs):____________________________________

___________________________________________________________________________________________________

19. Date use began: __________________________________________________________________________________

20. Is any portion of this property used by or leased to another person or entity? (

) Yes

(

) No

If yes, please answer the following questions:

a. Who uses the property and how is it used? __________________________________________________________

b. When did use begin? ___________________________________________________________________________

c. Is there a rental/usage fee charged by the applicant? (

) Yes

(

) No

If so, how is the amount calculated?___________________________________________________________________

d. What portion of the property is used by the person/entity? ______________________________________________

e. Please provide a copy of the lease or any other applicable agreement.

21. The undersigned submits the following information in support of this application (attach additional pages as necessary):

_______________________________________________________________________________________________

AFFIDAVIT:

I do hereby verify that the foregoing statements are true and correct to the best of my knowledge and belief.

_______________________________________

____________________________________________

Date

Signature

FOR OFFICIAL USE ONLY

( ) APPROVED:

( ) DENIED:

( ) PARTIAL:

EFFECTIVE DATE OF EXEMPTION :

COMMENTS:

By _________________________________________

Staff Attorney or State Board Designee

SBOE-6 RSVD. 02/13

Form Number: CT-0052

RDA 921

Application Form For Property Tax Exemption - Tennessee State Board Of Equalization Page 2