Fill - Free fillable Application For Ad Valorem Exemption

State of Oklahoma

Application for Ad Valorem Tax Exemption

for Charitable and Non Profit Entities

Exemption:

All property of any charitable institution organized or chartered under the laws of this state

as a nonprot or charitable institution, provided the net income from such property is used exclusively within

this state for charitable purposes and no part of such income inures to the benet of any private stockholder,

including property which is not leased or rented to any other than a governmental body, a charitable institution

or a member of the general public who is authorized to be a tenant in property owned by a charitable institution

under Section 501(c)(3) of the Internal Revenue Code, or property used exclusively and directly for charitable

purposes. Complete text, Ref. Title 68 O.S. 2887(8)(9).

Attach a copy of all Documents which support this application for exemption.

(Example: articles of incorporation, bylaws, resolutions, income-expense statements, rent rolls, deeds, contracts,

leases, etc.) Must provide a copy of IRS Section 501(c)(3) and your ling with Oklahoma Secretary of State.

It is impossible for this application to cover every provision addressed in the statutes related to exempt

charitable organizations. The assessor may contact you with additional questions depending on the answers

provided herein.

Please Print or Type

Real Property Owner:

Property Owner Name: ___________________________________________________________________________

Physical Address: _______________________________________________________________________________

Mailing Address: ________________________________________________________________________________

Contact Name: ______________________________________ Title: ____________________________________

Phone Number: ______________________ Email Address: ____________________________________________

Legal Description: _______________________________________________________________________________

Record of Deed: Date: ________________ Document Number: ____________ (or) Book/Page: ______________

Approximately what percentage of the property is requested to be exempt? _______ Square Footage: ____________

Are the Real Property Owner and the Charitable Organization the same? ............................................. Yes No

Are there currently other exemptions on this property?........................................................................... Yes No

If Yes, provide organization name(s) ______________________________________ Square Footage: ____________

Charitable Organization:

Charitable Organization Name: ____________________________________________________________________

Mailing Address: ________________________________________________________________________________

Contact Name: ______________________________________ Title: ____________________________________

Phone Number: ______________________ Email Address: ____________________________________________

Is the Charitable Organization requesting an exemption for its business personal property? ................ Yes No

If Yes, provide a listing of the personal property being claimed for exemption.

Is there other business personal property in use by the Charitable Organization which is not

being claimed for exemption?.................................................................................................................. Yes No

If Yes, provide a listing of the personal property not being claimed for exemption.

Continue application on page 2

Tax Year

2020

Revised 11-2019

OTC 988

Property Usage (Charitable Organization):

1. Describe the exact usage of the property being claimed exempt:

_________________________________________________________________________________________

2. Explain the exact usage of any net income from the property being claimed exempt:

_________________________________________________________________________________________

3. Does the Internal Revenue Service recognize this organization as a tax-exempt organization? .... Yes No

If Yes, attach a copy of letter from the Internal Revenue Service.

Is the organization chartered under the laws of the State of Oklahoma as a nonprot organization?

Yes No

If Yes, attach a copy of the articles of incorporation and bylaws.

5. Does the organization register annually with the Oklahoma Secretary of State’s Ofce? ............... Yes No

If Yes, attach a copy of registration.

6. Does the organization operate without prot or private advantage to its ofcials in charge? .......... Yes No

7. Do the patrons of the facility applying for the exemption receive the same services and

treatment irrespective of their ability to pay? ................................................................................... Yes No

8. Are the same charges made to all patrons regardless of ability to pay? ......................................... Yes No

9. What provisions, if any, have been made to dispose of surplus assets of the organization?

_________________________________________________________________________________________

Assessor Use Only

Assessor/Deputy: ___________________________________________ Date: ________________

Account Number: ___________________________________________

Application for Exemption: Approved Disapproved

School

District

I, ____________________________________ being duly sworn, upon oath, under penalty of perjury do hereby depose and say

that I am (Title) __________________________________, of __________________________________ (Charitable Organization);

that as such I am acquainted with the books, accounts, and affairs of the organization and know the foregoing statements

with respect to the organization to be true, correct and complete, and that all information requested of

the organization has been fully and correctly given (68 O.S. § 2945 provides penalties for false oaths).

Charitable Organization Affidavit:

Notary Seal

Signature: _______________________________________________________________________

Subscribed and sworn to before me this ___________ day of ___________________ , _________ .

My commission expires: ______________________ , _______________ .

____________________________________________________________________ , Notary Public

Application for Ad Valorem Tax Exemption for Charitable and Non Profit Entities

Form 988 • Page 2

I, ____________________________________ being duly sworn, upon oath, under penalty of perjury do hereby depose and say

that I am (Title) __________________________________, of ____________________________________ (Real Property Owner);

that as such I am acquainted with the books, accounts, and affairs of the property owner and know the foregoing statements

with respect to the ownership to be true, correct and complete, and that all information requested of the

real property owner has been fully and correctly given (68 O.S. § 2945 provides penalties for false oaths).

Real Property Owner Affidavit:

Notary Seal

Signature: _______________________________________________________________________

Subscribed and sworn to before me this ___________ day of ___________________ , _________ .

My commission expires: ______________________ , _______________ .

____________________________________________________________________ , Notary Public

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Fillable Application For Ad Valorem Exemption - Charitable (Oklahoma)

Fill Online, Printable, Fillable, Blank Application For Ad Valorem Exemption - Charitable (Oklahoma) Form

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