50-128 (Rev. 11-05/10) [11.23 Rule 9.415]
YEAR
APPLICATION FOR MISCELLANEOUS PROPERTY TAX EXEMPTIONS
Appraisal District Name Address Phone (Area code and number)
This application covers property you owned on January 1 of this year, or acquired during this year. You must file the completed form between January 1 and no later than April 30 of this year. If you acquire the property after January 1 of this year and wish to qualify for the exemption this year, you must apply before the first anniversary of the date you acquired the property, or before the first anniversary of the date any property was acquired after January 1. Be sure to attach any additional documents requested. You must apply for this exemption every year, except for exemption as a medical center development. This exemption will not be automatically renewed. For exemption as a medical center development or county fair association, you do not need to reapply annually once the chief appraiser grants the exemption. 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.
Step 1: Name and address of owner
Name of Owner Present Mailing Address City, Town or Post Office, State, ZIP Code Name of Person Preparing this Application Driver's License, Personal I.D. Certificate, or Social Security Number* Phone (area code and number) Title
Type of Owner (check appropriate box)
Individual
Association
Corporation
Nonprofit corporation County Fair Association Medical Center Development in Populous Counties
Step 2: Check type of exemption requested
Federation of Women's Clubs Nature Conservancy of Texas Congress of Parents and Teachers Private Enterprise Demonstration Association
Medical Center Development Community Service Club Scientific Research Organization Veterans' Organization
Step 3: Answer these questions about the organization
What is the organization's purpose?
Describe the organization's activities. (Attach additional sheets if necessary.)
Explain how the organization's activities relieve a burden or duty of the state or community. (Attach additional sheets if necessary.)
Is the organization affiliated with a state or national organization? Is membership in the organization open to anyone, regardless of race, religion or national origin?
Yes Yes
No No
Explain how the organization's activities promote the physical, mental and spiritual development of young people, development of patriotism and love of country and interest in community affairs. (Attach additional sheets if necessary.)
Continue on Page 2
50-128 (Rev. 11-05/10) - Page 2
All applicants answer these questions
Attach a copy of the charter, bylaws or other documents adopted by the organization which govern its affairs, and answer the following questions. Is your organization chartered by the United States Congress? ............................................................ Do these documents pledge the organization's assets for use in performing the organization's charitable functions? ............................................................................................................................... Yes No
Yes
No
If "YES," give the page and paragraph numbers.
Page ________
Paragraph ________
Do these documents require the organization to operate in a nonprofit manner? ................................
Yes
No
If "YES," give the page and paragraph numbers.
Page ________
Paragraph ________
Attach a list of salaries and other compensation for services paid in the last year. Also list any funds distributed to members, shareholders or directors in the last year. In each case, give recipient's name, type of service rendered or reason for payment and amount paid.
Step 4: Complete if County Fair Association
1. Does the association hold a license (issued after January 1, 2001) under the Texas Racing Act (Article 179e, Vernon's Texas Civil Statutes) to conduct a horse race meeting or a greyhound race meeting with pari-mutuel wagering? .......................................................................................................... 2. Does the association use the land or a building to conduct a race meeting or greyhound race meeting with pari-mutuel wagering under a license issued after January 1, 2001? ............................................... 3. Is the association a nonprofit corporation as defined by the Texas Non-Profit Corporation Act (Article 1396-1.01, et seq., Vernon's Texas Civil Statues)?........................................................................ 4. Is the association exempt from federal income taxes as an organization under Section 501(c)(3), (4), or (5), Internal Revenue Code of 1986, as amended? ............................................................................... 5. Is the association qualified for an exemption from the franchise tax under Section 171.060, Texas Tax Code? ........................................................................................................................................
Yes Yes
No No
Yes Yes
No No
Yes
No
Step 5: Describe your property
PROPERTY TO BE EXEMPT: · Attach one Schedule A (REAL PROPERTY) form for EACH parcel of real property to be exempt. · Attach one Schedule B (PERSONAL PROPERTY) form listing ALL personal property to be exempt. · List only property owned by the organization.
Step 6: Sign the application
· By signing this application, you designate the property described in the attached Schedules A and B as the property against which the exemption checked on page 1 may be claimed in this appraisal district. · You certify that this information is true and correct to the best of your knowledge and belief.
On behalf of (name of organization)
Date
Authorized signature
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.
50-128 (Rev. 11-05/10) - Page 3 [11-23-A]
Schedule A: Description of real property
· Complete one Schedule A form for EACH parcel qualified for exemption. · Attach all completed schedules to your application for exemption.
Name of owner Legal description of property Appraisal district account number (Optional): Describe the primary use of this property
__________________________________________________________________________________________________________
1. Is this property used exclusively for charitable purposes? ................................................................................................. 2. Is this property held for gain, rented or used with a view to profit? ................................................................................... 3. Is this property the organization's state headquarters? ...................................................................................................... 4. Is this property reasonably necessary for operation of the association/organization? ....................................................... 5. Is this property located in a medical center area where the organization has donated land to the state for hospital or medical school?........................................................................................... If "YES," is the medical center development complete? .................................................................................................... 6. Is the property currently under active construction or physical preparation?..................................................................... A. If under construction, when will construction be completed? (date) _______________________** B. If under physical preparation, check which activity the organization has done. (Check all that apply.) Architectural work Engineering work Soil testing Land clearing activities Site improvement work Environmental or land use study
Yes Yes Yes Yes
No No No No
Yes Yes Yes
No No No
7. Is the incomplete improvement designed and intended to be used by a qualified person for a purpose described by Section 11.23 (a)-(e), (g), or (i)-(k)? ................................................................................................................ 8. Is the land on which the incomplete improvement is located necessary for the use of the improvement for a purpose named in Question 7 above? ................................................................................................................................
Yes
No
Yes
No
List all other individuals and organizations that used this property in the past year, and give the requested information for each. NAME DATES USED ACTIVITY RENT PAID, IF ANY
Continue on additional sheets as needed. **An incomplete improvement exempted for the three years preceding the 2003 tax year is entitled to exemption for the 2003 tax year regardless of whether the property owner applies for the exemption for the 2003 tax year if the property otherwise qualifies. The chief appraiser may require the property owner to file an application to confirm the owner's qualification for exemption for the 2003 tax year. An exemption for an incomplete improvement is for five years. Effective January 1, 2006, the exemption will revert back to three years.
50-128 (Rev. 11-05/10 ) - Page 4 [11.23-B]
Schedule B: Description of personal property
· List all tangible property to be exempt on this schedule. · Attach all completed schedules to your application for exemption.
Name of owner
Is this property reasonably necessary for operation of the association/organization? .............................................................. Is this property held for gain? ..................................................................................................................................................... Is this property used exclusively for charitable purposes? ........................................................................................................ Is this property located in a medical center area where the organization has donated land for a state medical, dental or nursing school? .............................................................................................. If "YES," is the medical center development complete?....................................................................................................
ITEM LOCATION
Yes Yes Yes
No No No
Yes Yes
No No