50-310 (09-03) FORM A, Page 4 [11.1825, Rule 9.415]
SCHEDULE A: CONSTRUCTING LOW-INCOME HOUSING
Final Exemption Preliminary Determination of Exemption* Complete one Schedule A form for EACH land parcel of improved (with building) and unimproved real property qualified for exemption. Attach all completed schedules to your application for exemption.
Name of owner (please print): Property Address: City, state: Legal description of property: Describe the primary use of the property: ZIP code + 4: Appraisal district account number (Optional):
Date of acquisition of property: ______/______/_______
Is this property reasonably necessary for operation of the Organization?
Yes
No
Answer these questions about the property listed above: 1. If this is a preliminary determination of exemption, when the final application is filed is this property expected to be under "active construction" or "physical preparation?" If this is a final determination of exemption, is this property under "active construction" or "physical preparation?" If "active construction," when will construction be completed?
Active Construction
Physical preparation
Active Construction ______/______/______
Physical preparation
If "physical preparation," what has been done?___________________________________________________________________________________________
_____________________________________________________________________________________________________
"Physical preparation" is when the organization has engaged in architectural or engineering work, soil testing, land clearing activities, or site improvement work necessary for constructing the project or has conducted an environmental or land use study for construction of the project.
2. Does the organization plan to rent or sell dwelling units in this building to individuals or families? If rent, attach rent schedule. Questions regarding renting dwelling units: Do/will the individuals and families have a median income that is not more than 60 percent of either the area or statewide median family income? (Complete A or B): A. Area median family income for the household's place of residence, as adjusted for family size and as established by the United States Department of Housing and Urban Development, which is $ _______________, OR B. Statewide area median family income, as adjusted for family size and as established by the United States Department of Housing and Urban Development, which is $ ______________. What is the annual total of the monthly rent charged or to be charged for each dwelling unit in this building that is reserved for an individual or family? Will the organization be renting or offering to rent the applicable square footage of dwelling units in this building to qualified individuals and families by the third anniversary of the date the organization acquired this property? Questions regarding selling dwelling units: Do/will the individuals and families have a median income that is below either the area or statewide median family income? (Complete A or B): A. Area median family income for the household's place of residence, as adjusted for family size and as established by the United States Department of Housing and Urban Development, which is $ ______________, OR B. Statewide area median family income, as adjusted for family size and as established by the United States Department of Housing and Urban Development, which is $ ______________. 3. How many dwelling units does/will the above described property have? 4. What percentage of the total square footage of the dwelling units in this building described above are/will be reserved for individuals or families noted in question No. 2 above?
Rent
Sell
Yes
No
$_________ /year
Yes
No
______________ units _______________ %