Step 5. Sign the Application
Authorized Signature sign
Date
On behalf of (name of organization)
Title
4. Has every taxing unit listed above exempted the property by ordinance or order?
a. Attach a copy of ordinance or order.
5. Does the organization provide housing to the poor?
6. Does the organization provide housing for a fee?
7.
Is the program under which housing is provided operated by United States Department of Housing and Urban
Development?
8. Does the organization provide housing for more than a temporary period?
9. Are the resident individuals or a member of a family participating in a program to provide self-sufficiency?
10. Is the property leased from the United States or an agency of the United States?
a. Attach a copy of the lease.
b.
If the answer is "Yes," is the lessee a nonprofit organization?
Applicant's Name
Present Mailing Address (number and street)
City, Town or Post Office, State, ZIP code Phone (area code and number)
Name of person preparing this application Driver's License, Personal I.D. Certificate, or Title
Social Security Number*
Individual Association Corporation Nonprofit Corporation Governmental Entity
Application for Transitional Housing
Property Tax Exemption for _______
Year
Harris County Appraisal District
Exemption Center
13013 Northwest Fwy.
P. O. Box 922012
Houston, TX 77292-2012
(713) 957-7800
Form 11.111(01/2012)
This application covers property you owned on January 1 of this year. You must file the completed application between January 1 and no later than April 30 of this year. Be sure to attach any additional documents
requested. You must apply for this exemption every year; it will not be automatically renewed. If you have filled out this form online, you must print it, sign it, and mail it to the address above.
HCAD Account Number:
2. Legal Description
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 1. Applicant's Name and Address
Step 2. Describe Real Property
Step 3. List Taxing Units That Have Granted an Exemption on the Property
1. Taxing Unit 2. Taxing Unit 3. Taxing Unit
Step 4. Answer These Questions About the Organization
4. Yes No
5. Yes No
6. Yes No
7. Yes No
8. Yes No
9. Yes No
10. Yes No
b. Yes No
If this application is for an exemption from ad valorem taxation of property owned by a charitable organization with a federal tax identification number, that number
may be provided here in lieu of a driver's license number, personal identification certificate number, or social security ...................................number:
* Unless the applicant is a charitable organization with a federal tax identification number, the applicant's driver's license number, personal identification certifcate number, or social security account
number is required. Pursuant to TaxCode Section 11.48(a), a driver's license number, personal identification certificate number, or social security account number provided in an application
for an exemption filed with a chief appraiser is confidential and not open to public inspection. The information may not be disclosed to anyone other than an employee of the appraisal office
who appraises property, except as authorized by TaxCode Section 11.48(b). If the applicant is a charitable organization with a federal tax identification number, the applicant may provide the
organization's federal tax identification number in lieu of a driver's license number, personal identification certificate number, or social security account number.
1. Owner is a(n):
(please check)
