50-173 (Rev. 3-96/2) [23.19 (10-87) Rule 9.3052]
YEAR
REQUEST FOR SEPARATE TAXATION FOR COOPERATIVE HOUSING CORPORATION
Appraisal district name Address Phone (area code and number)
Appraisal District Use Only Legal description: Parcel number:
This request covers property owned by the cooperative housing corporation on January 1 of this year. You must file this completed form between January 1 and March 1 of this year. Be sure to attach any documents requested. If the chief appraiser grants the separate appraisal, you do not need to reapply annually. However, you must provide the chief appraiser with an updated list of stockholders, their interest and residency upon request. Return this completed form to the address above, with a payment of $ _____________ for this separate appraisal.
Step 1: Name, address and agent of corporation
Corporation name
Current mailing address (number and street)
City, town or post office, state, ZIP code Authorized agent Current mailing address (number and street)
Phone (area code and number)
City, town or post office, state, ZIP code
Cooperative housing corporation?
Yes
No
Step 2: Describe the property
Legal description
Street address
Step 3: Documents
File the following documents with this completed form: a. b. c. d. a list of names, addresses and proportionate interests of all stockholders in this property, indicating each stockholder that resides at this property; a resolution from the corporation's board of directors certifying that the stockholders approved this request for separate appraisal; a diagrammatic floor plan of the improvements on this property; and a survey plat map of the land showing location of the improvements.
Signature Date
sign Step 4: ± Sign and date here the application Name
Title
Corporation
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.