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2011-09-01 Outlot B-Tax Exempt Application Application for Property Tax Exemption Please read the back of this fort before completing. If you are applying for exemption as an institution of purely public charity, please fill out the "Institution of Purely Public Chanty Application for Property Tax Exemption" form. This section is to be completed by all applicants. Please provide the following information for the organization that owns the property on which exemption is being claimed. Name o 5 Nf organization r� I Date property acquired by organization Nam of representative o ner Title r Date of application Mailing address o organization 595 Y OI v enue P•U,13a City State zip County Pr be �11e N 55 3n�� k+ Is the above organization exempt from federal income tax under section 501(c)(3)? []Yes ❑ No The above organization is seeking exemption from property tax under the following category (please check one) ❑ Academy, college, university or seminary of learning El Public hospital ❑ Church, church property or house of worship ❑ Public school house Public property used exclusively for public purposes ❑ Other (specify) ❑ Public burying ground Institution of purely public charity (If yes, please file for exemption using the "Institution of Purely Public Chanty Application for Property Tax Exemption" form.) VLetogal tion is to be completed by all applicants. Please fill out the following information about the ; on which exemption is being claimed. dress 1 l 1 t C i,ti 1`\ 1'i �1v w r� Imo► 1 em e ��c �C'a 1 Fu J�.t QS rt State Zip County •. � 5301 t,D cription of the property Parcel ID number t- o� i )I- Ha-000 O a© ; This section fs to be completed by all applicants. Please answer the following questions about the ; use of the property. What is the principal use of the above-described property? Passe 61e_ Q-cmtyn2.- pia'' knWrown Qsuc r\oly Addifional uses of the above-described property (please give percentage of use): Are these uses directly related to the mission of the organization D�Yes ❑ No i Is any part of this property used for commercial purposes? ❑ Yes KNo If yes, please explain. � wrl n Why is ownership of this property necessary? Is any part of this property used for residential purposes? ❑ Yes je No If yes, please fill out next section. This section is to be completed if any part of the property is used for residential purposes. Please fill out the following information for each person who occupies the above - described property. List additional &z occup ant's information on a separate sheet and attach it to this application. Name of occupa t Nature of service/employment 0. ❑ Full time or El Part time .„ Is occupant required to reside on this property as a condition of employment? ❑ Yes ❑ No If yes, why is this required? Does occupant pay rent, either in cash or as a part of salary? ❑ Yes ❑ No If yes, please give details. Why is ownership of this residence necessary? Signature of owner or autitorized representative. By signing below/ certify that the above information is true and correct to the best of my knowledge, and I am the owner of the property or authorized representative of the organization that owns the property for which exemption is being claimed. Making false statements on this application is against the law. Minnesota Statute 609.41 states that anyone giving false information in order to avoid or reduce their tax obligations is subject to a fine of up to $3,000 and /or up to one year in prison. � Applicant's signal e ( t Daytime phone ;a Revised 01104 Applying for exemption from properly tax Filing for exemption No property will be exempt from Property which is subject to property Most taxpayers claiming exemption from taxation under Minnesota Statute tax on January 2 that is acquired by a property tax must file an application for 272.02 if the taxpayer claiming the government entity, institution of purely exemption with the assessor in the district exemption knowingly violates any of public charity, church or educational where the property is located on or before the provisions of this section. institution before July 1 of the year is February 1 of the assessment year. exempt for that assessment year if the Assessor may request property is to be used for an exempt For most exempt properties, this additional information purpose. application must be refiled every third Upon written request by the assessor, year. No matter what year the taxpayer taxpayers must make available to the How we use information initially files for exemption, applications assessor all necessary books and Some of the information contained on will again be due in 2004, 2007, 2010, etc. records relating to the ownership or use this form may be shared with the of property which can help verify county assessor, the county attorney, Churches, houses of worship, property whether or not the property qualifies the Commissioner of Revenue or other used solely for educational purposes by for exemption. federal, state or local taxing authorities academies, colleges, universities or to verify your eligibility for exemption. seminaries of learning and property Sale or purchase of exempt owned by the state of Minnesota or any property You do not have to give this of its political subdivisions are not information. However, refusal will required to file. Property which is exempt from property tax on January 2 and, due to disqualify you from consideration for sale or other reason, loses its exemption. Owners of some types of exempt property exemption prior to July 1 of that year, may be asked to complete a different will be placed on the current Penalties application instead of or in addition to assessment rolls for that year. Making false statements on this this form. application is against the law. The valuation will be determined with Minnesota Statute 609.41 states that In cases of sickness, absence, disability respect to its value on January 2 of anyone giving false information in or for other good cause, the assessor may order to avoid or reduce their tax extend the deadline for filing the such year. The classification will be statement of exemption for a period not based on the use to which the properly obligations is subject to a fine of up to st ate to exceed 60 days. was put by the purchaser, or in the $3,000 and/or up to one year in prison. event the purchaser has not utilized the What type of property property by July 1, the intended use of What the property, as determined by the qualifies for property p county assessor, based upon all Minnesota Statute 272.02 describes the relevant facts. types of property eligible for property tax exemption. The filing requirements can be found in Minnesota Statute 272.025. Revised 01 /04