Form Cta-Irbx - Industrial Revenue Bond Exemption Page 2
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6Industrial Revenue Bond Exemption
Page 2 of 6
1.
Real Property – For real property, provide a detailed description of all improvements, and attach
a copy of the deed.
_____________________________________________________________________________
_____________________________________________________________________________
2.
Personal Property – For personal property, provide an itemized list of all items, including the
acquisition date(s) and any legal documentation of ownership. (If the description is lengthy,
attach additional pages to this form.)
_____________________________________________________________________________
_____________________________________________________________________________
3.
Provide the lessee’s:
Company Name: _______________________________________________________
Address:
__________________________________________________________
Telephone #: __________________________________________________________
Company Contact: ______________________________________________________
4.
The Informational Statement required pursuant to K.S.A. 12-1744a, and amendments thereto,
must be on file before an exemption can be considered. Provide the filing number assigned to
that statement by the Board of Tax Appeals. ________________________________________
5.
Indicate the issuance date of the IRBs:_____________________________________________
6.
Indicate the total principal amount issued in IRBs.
$_____________________________
Of this total, how much in bond funds was expended to acquire, purchase, remodel, etc., in each
of the following categories?
Land
$_________________________________
Improvements
$_________________________________
Machinery, Equipment
$_________________________________
Property exempt
pursuant to K.S.A. 79-223
$_________________________________
Other (describe)
$_________________________________
_____________________
$_________________________________
TOTAL SPENDING
$_________________________________
7.
Indicate the total cost from all sources of acquiring, purchasing, remodeling or renovating this
property (by category):
Land
$_________________________________
Improvements
$_________________________________
Machinery, Equipment
$_________________________________
Property exempt
pursuant to K.S.A. 79-223
$_________________________________
Other (describe)
$_________________________________
_____________________
$_________________________________
TOTAL SPENDING
$_________________________________
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