Fillable APPLICATION FOR REAL ESTATE TAX EXEMPTION BY QUALIFYING (City of Winchester)

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APPLICATION FOR REAL ESTATE TAX EXEMPTION BY QUALIFYING (City of Winchester)

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Elected to Serve
Creamery Building Telephone: (540) 667-1815
21 South Kent Street, Suite 100 FAX: (540) 667-5298
Winchester, VA 22601 Website: www.winchesterva.gov
Email: cor@winchesterva.gov
APPLICATION FOR REAL ESTATE TAX EXEMPTION BY QUALIFYING
CLASSIFICATION OR DESIGNATION
For any answers that require more space, please include attachments
Tax Parcel ID#: _____________________ Acreage: _____________________________________
Property Owner: ______________________________________________________________________
Name of Organization (if different from Property Owner): ______________________________________
Mailing Address Street: ________________________________________________________________
Mailing Address City, State, Zip: __________________________________________________________
Property Address: ____________________________________________________________________
Legal Description of Property: ___________________________________________________________
1. Indicate the type of exemption desired: Classification _______ Designation _______
Exemptions by classification shall be strictly construed in accordance with Article X, Section 6(f) of
the Constitution of Virginia.
2. By what specific section of the Constitution and the Code of Virginia do you claim this exemption?
________________________________________________________________________________
3. Is the property ownership chartered or incorporated under the laws of the Commonwealth of Virginia?
Yes ______ No ______ (If yes, attach a copy of the charter)
4. For what purpose is the ownership chartered, incorporated or otherwise in existence?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Application for Tax Exemption, Page 2 of 3, Applicant: ______________________________________
5. For what purpose is the property being used? Please be specific and include use of acreage, if
applicable. If there are several types of use, indicate such usages by areas of the building, floor
locations and land allocations.
Acreage/Portion Description of Use Beginning Date
_____________ __________________________________________ __________________
_____________ __________________________________________ __________________
_____________ __________________________________________ __________________
_____________ __________________________________________ __________________
_____________ __________________________________________ __________________
6. Does any other individual, organization, association or corporation occupy or use any part of the
premises? Yes ______ No ______
If yes, give details: (How often, what part of the building or property, name of organization)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
7. Is any income, be it earnest money or in kind services, received from the use of any portion of the
property by other individuals or groups, whether considered as rent or reimbursement for necessary
expenses for services incurred? Yes ______ No ______
If yes, please give details: __________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
8. Does your ownership group have an exemption under U. S. Internal Revenue code so that gifts to
your group are deductible by the donor? Yes ______ No ______
(a) If yes, give date of Internal Revenue ruling: __________________________________________
(b) Give Internal Revenue Identification number: _________________________________________
Application for Tax Exemption, Page 3 of 3, Applicant: ______________________________________
9. REQUIRED DOCUMENTATION
(a) Attach to this application your most recent financial statement, including, where applicable, IRS
Forms 900; 990; 990EZ; 990T; reflecting income and expenditures for the most current twelve
(12) month reporting period, which statement will become a part of this application. The attached
financial statement is for the period from _____________ to ______________.
(b) Attach a copy of the organization’s Constitution, By-Laws, Articles of Incorporation, and/or other
related documents.
(c) Attach a list reflecting the names of all trustees or corporate/organization officers, the date
appointed or elected, and the court in which they qualified or identify the instrument in which they
were officially appointed.
(d) If investments, such as stock or bonds, are reflected on the financial statement, attach a list of all
such investments, including name of stock, date received and value.
(e) If applying for exemption by designation, please attach a check or money order made payable to
the ‘Commissioner of the Revenue’ in the amount of $350.00 for the applicable deposit for
publication as required under Section 27-32 of the City Code.
10. FILING DEADLINE AND EFFECTIVE DATE OF EXEMPTION
(a) For exemption by classification, the applicant may file at any time. The Commissioner of the
Revenue shall determine effective date of exemption based upon dates of qualifying ownership
and usage.
(b) For exemption by designation, the applicant must submit a completed application with all
supporting documentation on or before November 1. Applications, if fully approved, shall then
take effect July 1 of the following year.
For additional information, please refer to Code of the City of Winchester §§27-31 - 27-37, available on
the City’s website. The office of the Commissioner of the Revenue will gladly provide assistance with the
application process.
Application completed by: ______________________________________________________________
Title: __________________________________ Date Submitted: ____________________________
Contact person: _________________________ Telephone Number: _________________________
I, __________________________________________, an appointed or elected Trustee/Officer for the
above named organization, certify under penalty of law that this application and all attachments hereto
have been examined by me and all information is true and correct.
Signature of Trustee/Officer: ____________________________________________________________
Title: ____________________________________________ Date: __________________________
Subscribed and sworn to before me this ______ day of _______________________________________
Notary Public: ________________________________________________________________________
My commission expires: ________________________________________________________________
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APPLICATION FOR REAL ESTATE TAX EXEMPTION BY QUALIFYING (City of Winchester)

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Completed 22 March 2021

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