Free 50-121 Application for Dredge Disposal Site Exemption - Texas

50-121 (Rev. 8-03/7) [11.29 Rule 9.415]

APPLICATION FOR DREDGE DISPOSAL SITE EXEMPTION
Appraisal district name Address

YEAR

Phone (area code and number)

This application covers property you owned on January 1 of this year. You must file the completed application between January 1 and April 30 of this year. Be sure to attach any additional document requested. If the chief appraiser grants the exemption, you do not have to reapply annually. However, you must reapply if the chief appraiser requires you to do so or if you want the exemption to apply to property not listed in this application. You must notify the chief appraiser in writing if and when your right to this exemption ends. Return the completed form to the address above.
Owner's name

Step 1: Owner's name and address

Present mailing address City, town or post office, state, ZIP code Phone (area code and number)

Owner is a(n): (please check) Name of person preparing application Legal description:

Individual

Association

Corporation
Title

Nonprofit Corporation

Driver's License, Personal I.D. Certificate, or Social Security Number*:

Step 2: Describe the property

Appraisal district account number (Optional):

Is there a recorded easement dedicating this property for use as a disposal site for materials dredged from the main channel of the Gulf Intracoastal Waterway under federal or state supervision? ................................................................................................................... Is the property actively used as a dredge disposal site? ....................................................................... Attach a copy of the recorded document dedicating the property.

Yes Yes

No No

Step 3: Sign the application

By signing this application, you certify that this information is true and correct to the best of your knowledge and belief.

Signature

Date

On behalf of (name of organization)

Title

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.
* You are required to give us this information on this form, in order to perform tax related functions for this office. Section 11.43 of the Tax Code authorizes this office to request this information to determine tax compliance. The chief appraiser is required to keep the information confidential and not open to public inspection, except to appraisal office employees who appraise property and as authorized by Section 11.48(b), Tax Code.