Free BEFORE THE BOARD OF TAX APPEALS OF THE STATE OF KANSAS - Kansas

BEFORE THE COURT OF TAX APPEALS OF THE STATE OF KANSAS INDUSTRIAL REVENUE BOND EXEMPTION (K.S.A. 79-213) APPLICANT: (For State of Kansas use only) __________________________________________ Applicant Name (Owner of Record) __________________________________________ Applicant Address (Street or Box No.) __________________________________________ City State Zip Applicant Phone #:(____)_____________________ Applicant E-mail: ___________________________ Fee:_____________ Rec. Date:________ ATTORNEY OR REPRESENTATIVE: (If applicable)* No Fee:__________ __________________________________________ Representative Name Title __________________________________________ Representative Address __________________________________________ City State Zip Atty/Rep Phone #:(_____)_____________________ Representative E-mail:________________________ (For County use only) Reason: ____________ Amt Rec.___________ Ck #_______________

DOCKET NO.__________________-IRBX

Parcel ID #/Personal Property ID # or Vehicle ID #:

___________________________________
*Note: If you are represented by an attorney or other individual, you must provide the Court with either an Entry of Appearance or a current Declaration of Representative form approved by the Court of Tax Appeals. Tax Representatives are not permitted to sign applications filed with the Court.

___________________________________ ___________________________________

Taxing County:_____________________________ Year/Years at issue: _________________________ Property at issue:

County's valuation: $_____________________ LBCS Function Code: ____________________

Real Property---Street address, city:_________________________________________________ Personal Property---Description: ___________________________________________________
CTA-IRBX (Rev. 3/08)

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1.

Real Property ­ For real property, provide a detailed description of all improvements, and attach a copy of the deed. _____________________________________________________________________________ _____________________________________________________________________________

2.

Personal Property ­ For personal property, provide an itemized list of all items, including the acquisition date(s) and any legal documentation of ownership. (If the description is lengthy, attach additional pages to this form.) _____________________________________________________________________________ _____________________________________________________________________________

3.

Provide the lessee's: Company Name: _______________________________________________________ Address: __________________________________________________________

Telephone #: __________________________________________________________ Company Contact: ______________________________________________________ 4. The Informational Statement required pursuant to K.S.A. 12-1744a, and amendments thereto, must be on file before an exemption can be considered. Provide the filing number assigned to that statement by the Court of Tax Appeals. ________________________________________ Indicate the issuance date of the IRBs:_____________________________________________ Indicate the total principal amount issued in IRBs. $_____________________________

5. 6.

Of this total, how much in bond funds was expended to acquire, purchase, remodel, etc., in each of the following categories? Land Improvements Machinery, Equipment Property exempt Other (describe) _____________________ TOTAL SPENDING 7. $_________________________________ $_________________________________ $_________________________________

pursuant to K.S.A. 79-223 $_________________________________
$_________________________________ $_________________________________ $_________________________________

Indicate the total cost from all sources of acquiring, purchasing, remodeling or renovating this property (by category): Land Improvements Machinery, Equipment Property exempt Other (describe) _____________________ TOTAL SPENDING $_________________________________ $_________________________________ $_________________________________

pursuant to K.S.A. 79-223 $_________________________________
$_________________________________ $_________________________________ $_________________________________

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8.

Indicate whether the lessee is a corporation, a partnership, a limited liability company, etc. ___________________________________________________________________________ Describe specifically the nature of lessee's business. Copies of company brochures may be attached. ___________________________________________________________________________ ___________________________________________________________________________

9.

10.

Describe specifically the use of the property financed by the IRBs. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

11.

Is the bond-funded property at issue located in a Redevelopment Project Area as defined by K.S.A. 12-1770 et seq? _____No _____Yes Is the subject property, or any portion of it, used in a retail enterprise, poultry confinement facility, rabbit confinement facility, or swine production facility? _____No _____Yes If yes, list all property used for any of the above listed purposes. ____________________________________________________________________________ Has a previous application for exemption pursuant to K.S.A. 79-201a, or Article 11, §13 of the Kansas Constitution of the subject property been submitted to the Court? _____No _____Yes Years @ issue:________________ COTA Docket No.:__________________ Has a previous application for exemption pursuant to K.S.A. 79-201a, or Article 11, §13 of the Kansas Constitution for other property been submitted to the Court? _____No _____Yes Years @ issue:________________ COTA Docket No.:__________________ Enclose: a. The prepared cost-benefit analysis, which includes the effect of granting the exemption on state revenues. b. Proof of publication of the notice of public hearing concerning the granting of the economic development exemption and attach a publisher's affidavit showing publication at least 7 days prior to the hearing. c. A copy of the letter of notice of public hearing sent to the governing body of any city or county and unified school district within which the subject property is located. d. A copy of the ordinance or resolution adopted by the local governing body authorizing issuance of the IRBs. e. A copy of any lease or payment in lieu of tax agreements.

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16. 17.

Did you receive assistance from the Kansas Department of Commerce? _____Yes _____No Do you request a hearing on the application for exemption? _____Yes _____No

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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: ________________

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COUNTY APPRAISER RECOMMENDATIONS AND COMMENTS TO COUNTY APPRAISER: Pursuant to K.S.A. 79-213, and amendments thereto, the County Appraiser is required to review each application and recommend whether the relief sought should be granted or denied. Therefore, please answer the following questions and provide any additional comments you believe are necessary to support your recommendation. The County Appraiser shall provide a copy of the completed comments and recommendations to the applicant. 1. Do you find the facts as stated by the applicant represent the true situation?_____Yes _____No 2. Do you recommend that the exemption herein requested be granted? 3. Do you request a hearing on this application? _____Yes _____No _____Yes _____No

4. What was the total appraised valuation of the subject property as of January 1st of the year after the IRBs were issued? $__________________________ 5. What was the appraised valuation of the existing property prior to the IRB statement? $__________________________ 6. What is the mill levy for the subject property for the coming year (if set) or for the current year? Year ______________ Mill Levy ______________ Comments: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 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 County Official _____________________________________ Printed Name and Title State of ____________________ County of __________________ ) )

This instrument was acknowledged before me on __________ by ______________________________.

Seal

______________________________________ Signature of Notary Public

My appointment expires: ________________

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INDUSTRIAL REVENUE BOND EXEMPTION INSTRUCTIONS

(For assistance, contact the Kansas Department of Commerce (785) 296-5298) 1. Each application for tax exemption must be filled out completely with all accompanying facts and attachments. The statement of facts must be in affidavit form. Applications or statements that have not been signed by the property owner before a Notary Public will not be considered. Pursuant to K.S.A. 79-213, and amendments thereto, the property owner is required to file the application. If the subject property is leased, the lessee can not file the application. Pursuant to Kansas law, the burden is on the applicant to prove affirmatively that relief is necessary. Failure to do so will result in the denial of the request for exemption. Enclose any applicable filing fee(s) pursuant to K.A.R. 94-2-21. Checks or money orders should be made payable to the Court of Tax Appeals. For information regarding fees with the State Court of Tax Appeals, visit www.kansas.gov/cota/ or contact the Court at (785) 296-2388. The County Appraiser's office also has fee schedules available.

2.

3.

This form along with the applicable attachments is to be filed with the County Appraiser for recommendations pursuant to K.S.A. 79-213(d). The County Appraiser will forward the application to the Court of Tax Appeals.