Fillable RANDOLPH COUNTY TAX DEPARTMENT APPLICATION FOR PROPERTY TAX (Randolph County)

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RANDOLPH COUNTY TAX DEPARTMENT APPLICATION FOR PROPERTY TAX (Randolph County)

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RANDOLPH COUNTY TAX DEPARTMENT
APPLICATION FOR PROPERTY TAX EXEMPTION
NOTE: Application must be filed with the Tax Department by January 31
st
of the current year.
SECTION 1
The undersigned owner or authorized representative hereby petitions for exemption for the following described property beginning
January 1, 20____.
1. Owner _______________________________________________ Date _____________________________________
Address ___________________________________________________________________________________________
___________________________________________________________________________________________
2. Location of property _________________________________________________________________________________
3. Upon what uses or purpose do you base this claim for exemption of property taxes?
Religious YES [ ] NO [ ] - (Please complete Section 2)
Charitable YES [ ] NO [ ] " " "
Educational YES [ ] NO [ ] " " "
Literary YES [ ] NO [ ] " " "
Scientific YES [ ] NO [ ] " " "
Other YES [ ] NO [ ] - (Please add a written statement to support the claim for exemption)
SECTION 2
Please give an answer for all items:
1. Total number of lots or acres in this tract: ________________.
2. INSTRUCTIONS FOR ITEMS 2A - 2E: BUILDINGS & IMPROVEMENTS
A. Below in Section A, give the approximate size and description of the building(s) on this land.
B. Below in Section B, give the number of lots or acres occupied by the building(s) and any additional adjacent land
reasonably necessary for the convenient use of each building.
C. Below in Section C, describe how the building was used on January 1 of this year and is currently in use for worship or
activities that demonstrate and further the beliefs and objectives of a given church or religious body, or for nonprofit
educational, scientific, literary, or charitable purposes.
D. Below in Section D, state whether the building and land are being used completely and exclusively by the owner for the
purpose as stated in Section 1, item 3.
E. Office use only.
PLEASE GIVE CLEAR AND COMPLETE ANSWERS
____________________________________________________________________________________________________
Section A B C D E ____
Building Size Land Building & Exclusive Use Office
& Description Size Land Use Yes/No Use _____
1. | | | |
| | | |
| l l______________l________________
==================================================================================================
2. | | | |
| | | |
| | | |
==================================================================================================
3. | | | |
| | | |
| | | |
==================================================================================================
4. | | | |
| | | |
| | | |
==================================================================================================
3. Give the number of remaining lots or acres if any, and describe how all of this land is being used completely and exclusively for
purposes as stated in Section 1, Item # 3.
# of Lots _________________ __________________________________________________________________________
# of Acres _______________ __________________________________________________________________________
4. Please list buildings and land if any, which are not being completely and exclusively used for purposes as stated in Section 1,
Item # 3. ____________________________________________________________________________________________
____________________________________________________________________________________________________
5. Personal Property (Do not include registered motor vehicles - A separate application will need to be filed)
List personal property being used at the location _____________________________________________________________
____________________________________________________________________________________________________
6. Does any organization or individual other than the owner use this property: YES [ ] NO [ ] If YES, list the property being
used, the name of the user, the amount of time per month the property is used, and the income received per month for the
use of the property. __________________________________________________________________________________
__________________________________________________________________________________________________
==================================================================================
7. PLEASE READ AND COMPLETE THE AFFIRMATION
Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief, all information in this application is
true and correct, and is made for the purpose of exempting the property herein described from property taxation as allowed under
North Carolina law.
__________________________ _______________________________________________________________________
Today’s Date Signature of owner or authorized representative
Telephone: __________________________ Title ______________________________________________________________
Address: _____________________________________________________________________________________________
_____________________________________________________________________________________________
==================================================================================================
OFFICE USE ONLY:
Account # _____________________________ Pin # ________________________________________________________
Statute G.S. 105- _______Approved by ____________Partially Approved____________________________________________
Rejected by ______Reason For_________________________________ ______________________Fiscal Year ____________
EXAPPL – revised 9/03
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RANDOLPH COUNTY TAX DEPARTMENT APPLICATION FOR PROPERTY TAX (Randolph County)

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Completed 18 July 2020

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