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Kentucky Application For Exemption From Property Taxation Form

In the case of wanting to become exempt from property taxes in the State of Kentucky, the following form has to be completed and submitted.


Extracted Text for Proper Search

62A023 (4-10)Commonwealth of Kentucky
This application is to be used by organizations seeking property tax exemption pursuant to Section 170 of the Kentucky 
Constitution. Answer all questions as fully as possible and return the application and all attachments to the local Property Valuation Administrator.
Name(Print) Enter Exact Legal Name of Organization  Daytime Offi  ce & Cell Phone Numbers
(Print)Number and Street    City  County  State  ZIP Code
Mailing Address
(If Different from Above)(Print)
E-mail Address	Web Site:	
P.O. Box or Number and Street  City County State  ZIP Code	
Purpose of the 
Organization and 
Major Activity of 
State of
State	� Nonprofi t   � LLC  � Other _________________________	
County(ies) in 
Which Property
is Located
Type of
(check) � Public Property 
� Institution of Education  � Religious
�  Place of Burial  � Institution of Purely Public Charity
and  Signature For this property tax exemption application, I authorize the Department of Revenue \
(DOR) or its representative(s) 
to visit and inspect the property to be exempted now and in the future, to ensure the property is being used for tax-
exempt purposes. I hereby certify that the statements and information contained herein are correct to the best of my 
knowledge and belief and that I am authorized to sign this application.
Signed ______________________________________________   Title _________________________________________
Print  ________________________________________________   Cell Phone Number ___________________________
Date ________________________________________________
To be
Completed by 
the Property 
Recommendation _________________________________________________________\
Signed ___________________________________________  Date _____________________________________
Print _____________________________________________ (  )	
(  )	
Offi  ce of Property Valuation
Phone: 502-564-8338
Fax: 502-564-8368

1.  Who is the legal owner of the property? (Include all owners of an interest in the property and describe their interest.)
  2.  When was the property acquired?
  3.  (a).  How was the property acquired? 
    (b).  Provide a copy of the deed and a copy of the property record card (if a\
    (c).  Provide a picture of the property and buildings: “Exterior and Interi\
  4.  (a).  Has this organization previously been granted any tax exemption by the Commonwealth of Kentucky?\
  � Yes  � No  (If yes, describe.)
    (b).  Has this organization previously been granted any tax exemption under Section 501 of the Interna\
l Revenue  Code? � Yes  � No  (If yes, attach a copy of the authorization letter.)
  5.  Attach a statement detailing compensation, if any, to the following organization members:
  A.  Offi  cers
  B.  Directors
  C.  Trustees
    D.  Five Highest Paid Professional Service Employees
    E.  Five Highest Paid Employees
  6.  List the names and salaries of any family members serving in any capacit\
y in the organization.
  7.  List types of employees performing activities of the organization and their qualifi cations. Indicate which, if any, of  these persons receive compensation for their activities.
 8.  (a).  Is  any course of instruction offered on the property?  � Yes  � No  (If yes, describe the 
  (b). I s  i t   open to the public?  � Yes  � No  Is there any charge or fee required for 
attendance?  � Yes  � No  (If yes, how is the money utilized by the organization?)
  9.  Attach a resume of past activities in which the organization has partici\
pated in, present activities and future 
plans of the organization.
  10.  Describe the current use of the property.
  11.  Does or will this organization limit its benefi  ts, services or products to specifi  c classes of persons? 
   � Yes  � No  (If yes, explain.)

12.  Does the organization require the receipients or will they be required to pay a fee or other charge for the organization benefi  ts, services or products?  � Yes  � No  (If yes, explain.)
  13.  Does the property produce income?  � Yes  � No  (If yes, explain how the income is used.)
  14.  (a).  Does the organization operate a commercial establishment?  � Yes  � No  (If yes, indicate the 
names, addresses and a description of the property.)
    (b).  List Kentucky Sales and Use Tax Permit Account Number for each business that sells tangible personal  property.
    (c).  Describe the items of all real or tangible property. (General description only.) Include the location of any real  property, or describe the tangible personal property.
  15.  Is this organization fi  nancially supported, operated or controlled by any other organization?  � Yes  � No
    (If yes, list other organizations.)
  16.  Describe the applicant organization’s fund-raising program and explain to what extent it has been put into effect.
  17.  List all grants received during taxable years the organization has been in existence. (Show name of contributor, date,  amount of grant and brief description of the nature of the grant.)
  18.  Attach detailed  nancial statements, including both balance sheets and income and expense\
 statements, for the  two most recent accounting periods.
  19.  Attach copies of the Articles of Incorporation, bylaws and any amendment\
s to the Articles or bylaws as well as  any other information you wish to provide to help the Of  ce of Property Valuation issue a ruling.

Applicants seeking an exemption as a religious organization answer the following additional questions 
regarding the parcels for which an exemption is desired.
  20.  List all acreage and improvements owned by the applicant for which an exemption is desired. Include the number of acres for land and a general description of all improvements.
  21.  If multiple parcels, give a complete description of how each parcel in question 20 is being used. Examples of uses  to note include: religious worship services, minister occupied parsonage, held for future development, parking, 
fellowship hall, leased to another entity, etc.
  22.  (a).  If any of the property described in question 21 is a separate parking lot or garage, is \
the lot or garage rented  out during the week?  � Yes  � No  (If yes, give details.)
    (b).  Is the lot or garage essential for members to attend worship services?  � Yes  � No  (If no, give 

  §170. Property exempt from taxation— Cities may exempt factories for  ve  years.—There shall be exempted 
from taxation public property used for public purposes; places of burial not held for private or corporate profi  t, real 
property owned and occupied by, and personal property both tangible and intangible owned by, institutions of religion; 
institutions of purely public charity, and institutions of education not used or employed for gain by any person or 
corporation, and the income of which is devoted solely to the cause of education, public libraries, their endowments, 
and the income of such property as is used exclusively for their maintenance; household goods of a person used in his 
home; crops grown in the year in which the assessment is made, and in the hands of the producer; and real property 
maintained as the permanent residence of the owner, who is sixty-fi  ve years of age or older, or is classifi ed as totally 
d i s a bl e d  u n de r  a  pr o g r a m  aut h o r i z e d  o r  ad m i n i s t e r e d  by  a n  ag e n c y  of  t h e  Un it e d  S t at e s  gove r n m e nt  o r  by  a ny  r e t i r e m e nt  
system either within or without the Commonwealth of Kentucky, provided the property owner received disability 
pay ments pursuant to such disabilit y classifi   cation, has maintained such disability classifi   cation for the entirety of the 
particular taxation period, and has fi   led with the appropriate local assessor by December 31 of the taxation period, on 
forms provided therefor, a signed statement indicating continuing disability as provided herein made under penalty 
of perjury, up to the assessed valuation of sixty-fi  ve hundred dollars on said residence and contiguous real property, 
except for assessment for special benefi  ts. The real property may be held by legal or equitable title, by the entireties, 
jointly, in common, as a condominium, or indirectly by the stock ownership or membership representing the owner’s 
or member’s proprietary interest in a corporation owning a fee or a leasehold initially, in excess of ninety-eight years. 
The exemptions shall apply only to the value of the real property assessable to the owner or, in case of ownership 
through stock or membership in a corporation, the value of the proportion which his interest in the corporation bears 
to the assessed value of the property. The general assembly may authorize any incorporated city or town to exempt 
manufacturing establishments from municipal taxation, for a period not exceeding fi   ve  ye a r s,  a s  a n  i n du c e m e nt  t o  t h e i r  
location. Notwithstanding the provisions of Sections 3, 172, and 174 of this Constitution to the contrary, the General 
Assembly may provide by law an exemption for all or any portion of the property tax for any class of personal property. 
(Amendment, proposed Acts 1954, ch.111, §1, approved November, 1955; amendment, proposed Acts 1970, ch.186, §1, 
approved November, 1971; amendment, proposed Acts 1974, ch.105, §1, approved November, 1975; amendment, proposed 
Acts 1980, ch.113, §1, approved November, 1981; amendment, proposed Acts 1990, ch.151, §1, approved November, 1990; 
amendment, proposed Acts 1998, ch. 227, §1, ratifi  ed November, 1998.)
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