APPLICATION FOR EXEMPTION FROM LOCAL TAXATION

Property of Institutions and Organizations

Pursuant to 36 MRSA, Section 652

1.         To the Assessor(s) of_________________________________, Maine.

2.         Pursuant to 36 MRSA, section 652, the undersigned requests exemption from the property tax for the below               described real estate/personal property.

3.         Institution or Organization

                        NAME_____________________________________________________

                        ADDRESS_________________________________________________

4.         Location of real estate or personal property

                        Map_______________________ Lot_______________________

5.         The real estate and personal property is owned, occupied or used solely for the following purposes:

6.        The Person filing this application must present copies of Articles of Incorporation, By-Laws and Property Deed if not on file with the assessor.

7.         Person filing application

            NAME___________________________________               DATE_____________

            SIGNATURE____________________________

            TITLE________________________________

Check List for Assessor

Property of Institutions and Organizations

Pursuant to 36 MRSA, Section 652

1.         Incorporated by State of Maine_________________________________________________
            (Attach copy of Incorporation as filed with State)

2.         Property owned by this organization_____________________________________________
           (Attach copy of Deed(s))

3.         Property occupied by this organization  or other exempt organization______________________
            (Attach copy of Lease Agreement)

4.         Property used for Incorporated purposes__________________________________________           
           (Attach copy of By-Laws)

5.         Financial Report for Preceding Year_____________________________________________
            (Attach copy of Financial Report)