Antique Automobile Value Exclusion Application
County of , NC Application for Tax Year
Pursuant to N.C.G.S. §105-330.9, antique automobiles are designated a special class of property under Article
V, Sec. 2(2) of the North Carolina Constitution and are eligible for assessment at a reduced tax valuation. If
qualified, they shall be assessed at the lower of their true value or five hundred dollars ($500.00).
To determine qualification, the owner must file an affirmation with the assessor of the county in which the
property is located that all five conditions of the statute have been met. This form, or any appeal of initial value,
must be filed within 30 days of the date the taxes are due. The assessor reserves the right to deny the
qualification of any automobile deemed not to qualify.
Name of Titled Owner
Mobile Phone Email
Description of Property
Plate Nu mber Current Odometer Reading
Please answer the following questions:
1. Is your vehicle registered with the Division of Motor Vehicles, and have a historic vehicle special license plate
under N.C.G.S. §20-79.4? Yes No
2. Is your vehicle maintained primarily for use in exhibitions, club activities, parades, and other public interest
functions? Yes No
3. Is your vehicle used only occasionally for other purposes? Yes No
4. Is your vehicle owned by an individual, or owned directly or indirectly through one or more pass-through
entities, by an individual? Yes No
5. Is your vehicle used for the production of income or in connection with a business? Yes No
Affirmation of Applicant: Under penalties prescribed by law, I hereby certify that the above information is true
and correct to the best of my knowledge.
______________________________ ______________________________ __________________
Signature Printed Name Date
DO NOT submit this application to the NC Department of Revenue. Submit to the county assessor where the property is located.