Addition To Exemption Application Form Page 2
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3Addition to Exemption
K.S.A. 79-201b Fourth
Page 2 of 3
K.S.A. 79-201b Fourth (b) (Temporary Housing for Low Income Single-Parent Families)
1.
Name of organization.
_______________________________________________________________________________
2.
Explain how you determine that the residents are (1) single-parent families, (2) with limited or low
income, (3) in need of financial assistance. If you have a written policy or standard(s), please
provide a copy.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
3.
Is the subject property is used exclusively for temporary housing of 24 months or less?
_____Yes
_____No
If “No”, explain.
_______________________________________________________________________________
_______________________________________________________________________________
4.
Are the residents enrolled in a program to receive life training skills?
_____Yes
_____No
If “Yes”, explain the nature of the program.
_______________________________________________________________________________
_______________________________________________________________________________
5.
Provide a copy of the organization’s Articles of Incorporation. (If the organization is not a
corporation, provide other documentary evidence to show that the organization is a charitable or
religious organization.)
Revised 07/08
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