Harris County Appraisal District
Exemption Center
13013 Northwest Fwy
P. O. Box 922012
Houston, TX. 77292-2012
(713) 957-7800
Form 11.21(08/2013)
Application for Private School Property
Tax Exemption for _________
Year
Operator of school is a(n) (check one)
Individual Partnership Corporation Other (specify): _____________________________
Continue on Page 2
GENERAL INSTRUCTIONS: This application is for use in claiming property tax exemptions pursuant to Tax Code §11.21. This application
covers property you owned on January 1 of this year or acquired during this year. You must furnish all information and documentation required by
the application.
APPLICATION DEADLINES: You must le the completed application with all required documentation between January 1 and no later than
April 30 of the year for which you are requesting an exemption. If you acquired the property after January 1 of this year and wish to qualify for the
exemption this year, you must apply before the rst anniversary of the date you acquired the property, or before the rst anniversary of the date
any property was acquired after January 1.
If the chief appraiser grants the exemption, you do not need to reapply annually, but you must reapply if the chief appraiser requires you to do so,
or if you want the exemption to apply to property not listed in this application. You must notify the chief appraiser in writing if and when your right
to this exemption ends. Return the completed form to the address above.
OTHER IMPORTANT INFORMATION
Pursuant to Tax Code §11.45, after considering this application and all relevant information, the chief appraiser may request additional information
from you. You must provide the additional information within 30 days of the request or the application is denied. For good cause shown, the chief
appraiser may extend the deadline for furnishing the additional information by written order for a single period not to exceed 15 days.
Step 1: Provide Name and Address of School and Identity of Person Preparing Application
If this application is for an exemption from ad valorem taxation of property owned by a charitable organization with a federal
tax identication number, that number may be provided here in lieu of a driver’s license number, personal identication
certicate number, or social security number:
* Unless the applicant is a charitable organization with a federal tax identication number, the applicant’s driver’s license number,
personal identication certicate number, or social security account number is required. Pursuant to Tax Code Section 11.48(a), a
driver’s license number, personal identication certicate number, or social security account number provided in an application for an
exemption led with a chief appraiser is condential and not open to public inspection. The information may not be disclosed to
anyone other than an employee of the appraisal ofce who appraises property, except as authorized by Tax Code Section 11.48(b).
If the applicant is a charitable organization with a federal tax identication number, the applicant may provide the organization’s
federal tax identication number in lieu of a driver’s license number, personal identication certicate number, or social security
account number.
Step 2: Name and Mailing Address of School Owner
Name of Person Preparing this Application Title Driver’s License, Personal I.D. Certicate,
or Social Security Number*
Name of School Owner
Mailing Address
City, State, ZIP Code Phone (area code and number)
Name of School Owner
Mailing Address (if different from above)
City, State, ZIP Code Phone (area code and number)
11.21 (08/2013) Page 2
1. Does the school use its assets in performing its educational functions or the educational functions of another
educational organization?
2. Do these documents direct that on the discontinuance of the school the school’s assets are to be transferred
to the State of Texas, the United States, or to an educational, religious, charitable, or other similar organization
that is qualied for exemption under Sec. 501(c)(3), Internal Revenue Code as amended?
a. If “Yes,” give the page and paragraph numbers. Page _______ Paragraph _______
Property to be Exempt:
• Attach one Schedule A (Real Property) form for EACH parcel of real property to be exempt.
• Attach one Schedule B (Personal Property) form listing ALL personal property to be exempt.
• By signing this application, you designate the property described in the attached Schedules A and B as the property against
which the private school exemption may be claimed in this appraisal district.
• You certify that this information is true and correct to the best of your knowledge and belief.
If you make a false statement on this application, you could be found guilty of a Class A misdemeanor or a
state jail felony under Texas Penal Code Section 37.10.
Step 5. Answer These Questions about the School’s Bylaws or Charter
Step 6. Describe Your Property
Step 7. Read, Sign, and Date
Authorized Signature
sign
here
Date
On behalf of (name of property owner) Title
Step 4. Answer These Questions About the School’s Finances
Application for Private School Property Tax Exemption
Step 3. Answer These Questions About the School
1. Does anyone other than the owner operate the school?
a. If “Yes,” is the operator the former owner of the property?
2. Does the school maintain a regular faculty and curriculum?
3. Does the school have a regularly organized body of students?
4. Do classes normally meet at one of the buildings to be exempted?
1. In the past year has the organization loaned funds to, borrowed funds from, sold property to or bought property
from a shareholder, director, or member of the organization, or has a shareholder or member sold his interest
in the organization for a prot?
a. If “Yes,” attach a description of each transaction. For sales, give buyer, seller, price paid,value of the property
sold and date of sale. For loans, give lender, borrower, amount borrowed, interest rate, and term of loan
Attach a copy of note, if any.
2. Does the organization operate in such a manner that does not result in the accrual of distributable prots, the
distribution of prots, or the realization of any other form of private gain?
Attach a copy of the charter, bylaws, or other documents adopted by the school which govern its affairs, and answer the following questions.
1. Yes No
2. Yes No
1. Yes No
2. Yes No
1. Yes No
a. Yes No
2. Yes No
3. Yes No
4. Yes No
1. Is this property used exclusively for school purposes?
2. Is this property held for gain, rented, or used with a view to prot?
3. Is this property the organization’s state headquarters?
4. Is the property currently under active construction or physical preparation?
If you answered “Yes,” to this question, please answer the following questions:
a. If under construction, when will construction be completed (date) ______________________
b. If under physical preparation, check which activity the organization has done.
(Check all that apply. Please attach supporting documentation.)
Architectural Work Land Clearing Activities Engineering Work
Site Improvement Work Soil Testing Environmental or Land Use Study
5. Is the incomplete improvement designed and intended to be used for a qualied private school purpose?
6. Is the land on which the improvement is located reasonably necessary for the use of the improvement for
the operation of the qualied private school?
Schedule A: Description of Real Property
· Complete one Schedule A form for EACH parcel qualied for exemption.
· Attach all completed schedules to your application for exemption.
HCAD Account Number
11.21 (08/2013) Page 3
Name of Property Owner *
Legal Description of Property (also attach copy of deed(s))
Describe the primary use of this property.
2. Yes No
3. Yes No
4. Yes No
1. Yes No
5. Yes No
6. Yes No
Name Dates Used Activity Rent Paid, if any
Application for Private School Property Tax Exemption
* If property owner is a religious organization, attach a copy of the school’s lease agreement.
Continue on additional sheets as needed.
Tax Year _______________________________
List all other individuals and organizations that used this property in the past year, and give the requested information for each.
Is this property reasonably necessary for operation of the school?
Is this property held for gain?
Is this property used exclusively for school purposes?
Schedule B: Description of Personal Property
· List all tangible property to be exempt on this schedule.
· Attach all completed schedules to your application for exemption.
Item Location
Name of Property Owner:
11.21 (08/2013)
HCAD Account Number
Yes No
Yes No
Yes No
Application for Private School Property Tax Exemption
Tax Year _______________________________