Free Applicant Name - Kansas


File Size: 19.9 kB
Pages: 3
Date: March 19, 2009
File Format: PDF
State: Kansas
Category: Tax Forms
Author: Kathleen A Shea
Word Count: 387 Words, 3,616 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.kansas.gov/cota/documents/TXAdd201bFourth.pdf

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Addition to Exemption K.S.A. 79-201b Fourth Page 1 of 3

Applicant Name: ________________________ Docket No.:_____________________________

Addition to Exemption Application K.S.A. 79-201b Fourth (Housing for Low Income Persons)
(Instructions: Please complete only one of the two sections below based upon the subsection of the statute under which exemption is requested, either K.S.A. 79-201b Fourth (a) or K.S.A. 79-201b Fourth (b).)

K.S.A. 79-201b Fourth (a) (Housing for Low Income Elderly or Handicapped Persons)

1.

Name of organization. _______________________________________________________________________________

2.

List the specific Federal programs under which financing was received for the subject property. _______________________________________________________________________________ _______________________________________________________________________________

3.

If the organization operates cooperative housing pursuant to Sections 236 or 221(d)(3), or both, of the National Housing Act, provide documentary evidence. Enclose the following documentation: A copy of the Articles of Incorporation and Bylaws of the organization. A copy of the Certificate of Good Standing issued by the Kansas Secretary of State demonstrating that the organization is currently active and in good standing.

4.

Revised 07/08

Addition to Exemption K.S.A. 79-201b Fourth Page 2 of 3

K.S.A. 79-201b Fourth (b) (Temporary Housing for Low Income Single-Parent Families)

1.

Name of organization. _______________________________________________________________________________ Explain how you determine that the residents are (1) single-parent families, (2) with limited or low income, (3) in need of financial assistance. If you have a written policy or standard(s), please provide a copy. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

2.

3.

Is the subject property is used exclusively for temporary housing of 24 months or less? _____Yes _____No If "No", explain. _______________________________________________________________________________ _______________________________________________________________________________

4.

Are the residents enrolled in a program to receive life training skills? _____Yes _____No If "Yes", explain the nature of the program. _______________________________________________________________________________ _______________________________________________________________________________

5.

Provide a copy of the organization's Articles of Incorporation. (If the organization is not a corporation, provide other documentary evidence to show that the organization is a charitable or religious organization.)

Revised 07/08

Addition to Exemption K.S.A. 79-201b Fourth Page 3 of 3

VERIFICATION

I, ________________________________, do solemnly swear or affirm that the information set forth herein is true and correct, to the best of my knowledge and belief. So help me God.

_______________________________________ Signature of Applicant _______________________________________ Printed Name and Title State of ____________________ County of __________________ ) )

This instrument was acknowledged before me on __________by________________________________.

Seal

______________________________________ Signature of Notary Public

My appointment expires: ________________

Revised 07/08