Form Av-12 - Application For Business Property Tax Exemption

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YEAR ___________________
Form AV–12
Web
10–02
APPLICATION FOR BUSINESS PROPERTY TAX EXEMPTION
County _______________ City or Town _______________
Trade Name of Business
Name of Owner
Location of Property
Mailing Address
INSTRUCTIONS
Under the provisions of G.S. 105–282.1, every owner of the types of property described below claiming exemption
or exclusion from property taxes thereon must demonstrate that it meets the statutory requirements for exemption
or classification. Claims for exemption or exclusion must be filed annually with the Assessor of the county in which
the property is located during the statutory listing period. (See Reverse Side)
The undersigned owner or authorized representative hereby petitions for exemptions or exclusion of the following
described property.
Taxpayers Cost
( ) 1. Imported property held at seaport terminal
105–275(2)
( ) 2. Special nuclear materials
105–275(6)
*
( ) 3. Property used for pollution abatement and recycling
105–275(8)
( ) 4. Motor vehicle chassis temporarily entering the State
105–275(14)
for having a body mounted thereon.
( ) 5. Property held in a foreign trade zone
105–275(23)
( ) 6. Cargo containers and chassis used in ocean commerce
105–275(24)
( ) 7. Tangible Personal Property shipped into this State for repair
105–275(25)
or service and reshipment to the owner outside this State
( ) 8. Advances on farm products by U. S. Govt. Agency or
105–277.01
cooperative marketing association
TOTAL
* Application only required one time unless there are additions to the property or a change in ownership.
The above statutory citations are for identification purposes only.
Full texts of all exemption and classification statutes are available at the office of the county Assessor.
AFFIRMATION
Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief, the statements in this
application are true and correct and are made for the purpose of exempting the property herein described from taxation. I
further affirm that the amounts claimed on this form are taken from the records of the taxpayer and may be verified from
said records.
20
Signature of owner or authorized representative
Title
Telephone No.
APPROVED
YES
NO

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