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<br />Fenn AV-10
<br />(Rev 6-97)
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<br /> APPIJCA71t~(~E FOR PROP~R1''r i'AX r;twl1r1P71ov .
<br /> County _ ( >,_~ ~t• Town or City
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<br />---- _.~__.__,._ INSTRUCTIONS ~ ~'~~"-'--"
<br />Under the provisions of G. S. 105-282.1 every owner of property claiming exemption or exclusion from property taxes must demonstrate that the properly
<br />meets the statutory requirements for exemption or classification. Claims for exemption or exclusion must bo riled with the Assessor of the county in
<br />which the property is Iccated.. (see reverse side) Claims for exemption should Include alt land and Improvements and personal property situated (hereon
<br />and complete inlormation regarding its use.
<br />The undersigned owner or authorized representative hereby petitions (or exemption of the lollowiny described property:
<br />2. Give complete description of proporhy:__ ~ ,,.~ ~nl ir:_v„ F~.ria •~._~"~„__ _~
<br />Improvements:
<br />Personal
<br />3, List anr~ explain the purposes for which the property is used:
<br />Land: •1 _~_,r-r.!`-(_ `~' n,.,.c~=.r~: ,c•.,~ r7~,.nc.'~ ~.
<br />Improvements: _~__,.~,
<br />Personal Properly:~~,
<br />4. If any organization other than the owner uses the property, give the name of the organization, IuII particulars regarding its use of the
<br />properly and the amount of any income received for such use, ._~_i1~_,~~~ _ __~ _`~~
<br />5.. Give your estimate of the true value In money of the property:
<br />Land: rl-'~-~-.• El r,t.., "`~-
<br />Itnprovements:.. ` -':7
<br />Personal Property:.~._
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<br />6, Upon what uses or purposes do you base (his claim for exemption? Charitable ( ); Religious ( ); Educational ( );
<br />Literary ( ); Scientific ( ); Other. -•~r^•,,. ~r:: ;,~, ~. his \,r^~.;,,,. .,,,. - ,
<br />~~ .L~Sl... .5..:.::1.1.:.... ,-r.-1i^ 1t^t:~ ~\\,.. f. ,. .-P._. 't ~,. n,~l\,+~-
<br />7. Give the specific statutory authority upon which this property is claimed as exempt: i (-. ~^ `_-~`~°-~.u~. 7 ~~ ~~ _,~~~
<br />(Full texts of al! exemption and classification statutes are avai(ablr at the office of the county Assessor)
<br />AFFIRMATION
<br />Under penalties prescribed by law, I hereby ailirm that to the best of my knowledge and belief, the statements and information In this
<br />application are true and correct, and are made for the purpose of exempting the property herein described from taxation.
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<br />Signaturere o~r or auUiuiiied-represenlalivo
<br />APPROVED ~ YES C~ NQ TUIo ~ Telcohhone Flo.
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