Form Cta-Irbx - Industrial Revenue Bond Exemption
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6BEFORE THE BOARD OF TAX APPEALS OF THE STATE OF KANSAS
INDUSTRIAL REVENUE BOND EXEMPTION
(K.S.A. 79-213)
APPLICANT:
(
)
For State of Kansas use only
__________________________________________
Applicant Name (Owner of Record)
__________________________________________
Applicant Address (Street or Box No.)
__________________________________________
City
State
Zip
DOCKET NO.__________________-IRBX
Applicant Phone #:(____)_____________________
Fee:_____________
Amt Rec.___________
Applicant E-mail: ___________________________
Rec. Date:________
Ck #_______________
ATTORNEY OR REPRESENTATIVE:
(If applicable)*
No Fee:__________
Reason: ____________
__________________________________________
Representative Name
Title
__________________________________________
Representative Address
(
)
For County use only
__________________________________________
City
State
Zip
Parcel ID #/Personal Property ID #
Atty/Rep Phone #:(_____)_____________________
or Vehicle ID #:
Representative E-mail:________________________
___________________________________
___________________________________
___________________________________
Taxing County:_____________________________
County’s valuation: $_____________________
Year/Years at issue: _________________________
LBCS Function Code: ____________________
Property at issue:
Real Property---Street address, city:_________________________________________________
Personal Property---Description: ___________________________________________________
CTA-IRBX (Rev. 7/14)
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Parent category: Financial