Further Statement Of Organization Claiming Property Tax Exemption {FS}

FURTHER STATEMENT OF ORGANIZATION CLAIMING PROPERTY TAX EXEMPTION (N.J.S.A. 54:4-4.4; & 54:4-3.5; 54:4-3.6; 54:4-3.6a; 54:4-3.9; 54:4-3.10; 54:4-3.13; 54:4-3.15; 54:4-3.24; 54:4-3.25; 54:4-3.26; 54:4-3.27; 54:4-3.35; 54:4-3.52; 54:4-3.64; & N.J.S.A. 8A:5-10 et al) IMPORTANT File this claim in duplicate with municipal assessor of taxing district where property is located no later than November 1 of every third succeeding year, updating the organization's status. Separate claims must be filed for each parcel. See instructions. 1. CLAIMANT ORGANIZATION NAME __________________________________________________________________________________________________ 2. ORGANIZATION ADDRESS (Corporate Headquarters) __________________________________________________________________________________________________ 3. CONTACT INDIVIDUAL, REPRESENTATIVE, OFFICER for ORGANIZATION __________________________________________________________________________________________________ Name Phone # Postal Mailing Address E-Mail Address Fax # __________________________________________________________________________________________________ 4. EXEMPT PROPERTY LOCATION IN NEW JERSEY for which continued exemption is claimed __________________________________________________________________________________________________ Street Address County Municipality City Block # Lot # Zip Code Qualifier __________________________________________________________________________________________________ 5. CONFIRMATION OF FILING OF INITIAL STATEMENT Initial Statement claiming exemption from taxation for the above mentioned real property in item #4 was filed on _____________________ with the assessor of the aforementioned municipality. (Date) 6. PHYSICAL and/or USE CHANGES of the aforementioned real property in item #4 Fully describe any physical changes that have occurred since the filing of the previous Initial or Further Statement. Total Land Area (Sq. Ft./Acreage) ________________ Land is Vacant or Improved with buildings and/or structures? (Check one) If improved, state number of buildings and/or structures ____________State building(s) size in square feet _____________ Fully describe building(s)/structure(s) type ________________________________________________________________ State $ amount for which improvements are insured _________________ Fully describe any changes in the use that have occurred since the filing of the previous Initial or Further Statement. If vacant land, state purpose, area used and size for each use. If not used, state none ________________________________ ___________________________________________________________________________________________________ If improved with buildings and/or structures, state uses of each.________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ Are land and/or buildings used for originally stated purposes of claimant organization? No Yes If yes, Entirely or Partially? Explain if used for other than claimant organization's purposes or if used or occupied by other than the claimant organization ______________________________________________________________________ ___________________________________________________________________________________________________ Are land and/or buildings leased or rented by other than claimant organization? No Yes If yes, Entirely or Partially? Percentage of property leased ______% Attach copy lease/rental agreement. Explain rental uses____________________________________________________________________________________ State tenant names and rental income received. ___________________________________________________________________________________________________ Is commercial business conducted on premises? No Yes If yes, explain ___________________________________________________________________________________________________ 7. COMPENSATION/REMUNERATION CHANGES Fully describe any changes that have occurred since the filing of the previous Initial or Further Statement. List names of individuals, officers, entities receiving compensation, salaries, allowance, monetary profits from claimant organization and dollar amounts received. If none, state none. Supporting financial data may be required by assessor. ___________________________________________________________________________________________________ 8. PROPERTY OWNERSHIP CHANGES/DISPOSITIONS Has any portion of the real property described in item 4, for which exemption has previously been claimed and allowed, been rented, sold or otherwise disposed of since the filing of the prior Initial or Further Statement? Yes No If yes, describe the property and state to whom conveyed and date of conveyance. _________________________________ ___________________________________________________________________________________________________ 9. PROPERTY NEWLY ACQUIRED for which exemption is claimed Has any new or additional real property been acquired by claimant since the filing of the previous Initial or Further Statement? Yes No Property Location ______________________________________________________________ If yes, an Initial Statement, Form I.S., as to such new or additional real property must be filed with the assessor. 10. SIGNATURE, DATE & TITLE OF OFFICER CLAIMING EXEMPTION FOR ORGANIZATION I certify the above declarations are true to the best of my knowledge and belief and understand they will be considered as if made under oath and subject to penalties for perjury if falsified. Signature_______________________________ Official Title or Position _______________________Date___________ Official Use Denied Approved Exempt Property Code______________________________ Assessor______________________________________________________________________Date__________________ Form F.S. Rev. April 2002. This form is prescribed by the Director, Division of Taxation, as required by law, and may not be altered without the approval of the Director. American LegalNet, Inc. www.FormsWorkflow.com FURTHER STATEMENT REQUIRED: Every third year as of November 1 after approval of the Initial Statement, a Further Statement is to be filed with the municipal assessor. IMPORTANT File this claim in duplicate with municipal assessor of taxing district where property is located by November 1. Separate claims must be filed for eac