Application For Exemption From Business, Professional And Occupational License Tax And/or Business Personal Property Tax Page 2
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1
2A
E
PPLICATION FOR
XEMPTION FROM
B
, P
O
L
T
USINESS
ROFESSIONAL AND
CCUPATIONAL
ICENSE
AX
/
B
P
P
T
AND
OR
USINESS
ERSONAL
ROPERTY
AX
F
N
-
C
, E
,
R
O
OR
ON
PROFIT
HARITABLE
DUCATIONAL
OR
ECREATIONAL
RGANIZATIONS
8.
Does the organization own any real estate, tangible personal property, or vehicles? If yes, please provide
a detailed listing of all property which includes the items’ description, acquisition date, acquisition cost,
state vehicle identification number (VIN), vehicle make, and vehicle model.
Itemized Listing Attached? ____ Yes ___ No (Please Explain)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
9.
Please enclose a copy of each of the following documentation* with this exemption application. If any of
these documents are not available, please identify the document and provide a brief explanation.
Articles of Incorporation/Organization
Bylaws/Constitution
IRS Letter of Exempt Designation
Mission Statement
Recent Federal Tax Filing (Forms 990/990T)
Recent Financial Statements
Pamphlets, Brochures, Weekly Bulletins, Annual Reports, News Letters, Course Catalogs, Membership
Directory, Advertising, Tuition/Fee Scales, Certifications or Accreditations, Visitor or New Member
Information Packets, or Promotional Literature (Anything which describes the charitable, benevolent,
educational or recreational purpose for which the organization was established.)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
10.
The space below is provided for any additional comments or remarks the organization desires to make.
Please reference the question number should the comment pertain to a particular item requested above.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11.
Please sign this application certifying that to the best of your knowledge and belief the information
provided herein is complete and accurate.
Signature
_________________________________________________________________
Printed Name
_________________________________________________________________
Title
_________________________________________________________________
Date
_________________________________________________________________
* Unincorporated churches which do not have Articles of Incorporation, an IRS determination letter, or Federal Tax Returns,
please supply as much documentation as is available to confirm the establishment of a church which holds regularly scheduled
and on-going worship services and provides charitable services for the community.
Fairfax County Department of Tax Administration, Personal Property Division
12000 Government Center Parkway, Suite 261
Fairfax, VA 22035
Phone: 703-222-8234; TTY: 703-222-7594; Fax: 703-324-4171
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