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      INITIAL 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 by 
November 1 of the pretax year          . Separate claims must be filed for each parcel. Every third year as of November 1     a 
Further Statement updating the organization’s status must be filed with the assessor. See instructions. 
 
1. CLAIMANT ORGANIZATION NAME 
__________________________________________________________________________________________________ 
2. ORGANIZATION ADDRESS (Corporate Headquarters) 
__________________________________________________________________________________________________ 
3. CONTACT INDIVIDUAL, REPRESENTATIVE, OFFICER for ORGANIZATION 
__________________________________________________________________________________________________ 
Name                                                 Phone #                       E-Mail Address                  Fax #
__________________________________________________________________________________________________ 
Postal Mailing Address 
__________________________________________________________________________________________________ 
 
4. INCORPORATION 
A. Domestic-Incorporated or organized in New Jersey on (month/day/year) _________under statute cite #_____________ 
B. Foreign-Incorporated or organized in the state of ______________  on (month/day/year) ________________________ 
Registered with New Jersey Secretary of State on (month/day/year)  ___________________________________________ 
5. ORGANIZATION’S PURPOSES (Explain organization’s purposes. Attach Certificate of Incorporation, Articles of 
Association, Charter/Mission Statement, and Constitution & By-laws.) 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
6. NEW JERSEY STATUTE UNDER WHICH PROPERTY TAX EXEMPTION IS CLAIMED 
State New Jersey statute cite # and brief description (see list in instructions) 
__________________________________________________________________________________________________ 
7. PROPERTY LOCATION IN NEW JERSEY 
__________________________________________________________________________________________________ 
Street Address       City        Zip Code        
__________________________________________________________________________________________________ 
County                                 Municipality                         Block #                   Lot #        Qualifier
8. PROPERTY OWNERSHIP 
Grantor (Seller) _______________________________  Grantee (Buyer) _______________________________________ 
Deed Date (Month/Day/Year) ____________________  Deed Book _________________                                Page _______________ 
County of recording ____________________________ Recording Date _______________________________________ 
Owner of legal title   ! Yes    ! No     If no, describe ownership arrangement.     Attach ownership document. 
__________________________________________________________________________________________________ 
9. PROPERTY’S PHYSICAL DESCRIPTION 
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 each building size in square feet ___________________________________________________________________ 
Fully describe each building/structure type _______________________________________________________________ 
State $ amount for which improvements are insured __________________ 
10. PROPERTY’S ACTUAL USE or ACTUAL/EXCLUSIVE USE 
If vacant land, state uses and area 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 stated purposes of claimant organization per section 5 above? 
! 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 ____%                 Attachcopy lease/rental agreement. 
Explain rental uses. _________________________________________________________________________________ 
State tenant names and rental income received. 
__________________________________________________________________________________________________ 
Is commercial business conducted on premises?  ! No    !Yes   If yes, explain __________________________________ 
11. COMPENSATION, REMUNERATION RECEIVED 
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. 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
12. 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 I.S. Rev. December 2001. 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. 



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                                                      INFORMATION/INSTRUCTIONS 
 
GENERAL ELIGIBILITY: Real property tax exemption is determined by: 
1. the organization’s purpose 
2. the property’s use as of October 1 of the pretax year 
3. the absence, presence, degree and use of profits 
4. the property’s ownership as of October 1 of the pretax year 
5. incorporation of the organization or its authorization to operate in New Jersey 
6. land area or existing buildings 
7. timely application as of November 1 of the pretax year 
 
   Because eligibility criteria varies from statute to statute, specific questions regarding your organization’s exemption 
   requirements should be directed to the municipal assessor in the taxing district where the property is located. 
 
LAND & BUILDINGS: Land and building criteria vary depending on statute under which exemption is claimed. Although 
there are some exceptions; such as cemetery and conservation land, vacant land IS NOT         generally exempt even when owned by 
an otherwise exempt organization. In most cases, in the absence of buildings used for one of the exempt purposes specified by 
statute, independent vacant land is not exempt. Also most statutes impose acreage limits on exemptable land area. A common 
limit is five acres per exempt building. Please review applicable statute. 
 
OWNERSHIP: Property must be owned by the organization claiming exemption as of October 1 of the pretax year. For 
example, possession of legal title as of October 1, 2000 would fulfill the ownership prerequisite for exemption for tax year 
2001. In most cases, full legal title must be acquired; equitable title is insufficient. However, certain statutes by specific 
provision allow for equitable or beneficial ownership interest. Please review the statute under which you are requesting 
exemption with respect to eligible ownership. 
 
EXEMPT USE TEST-REASONABLE NECESSITY: Use must be a qualifying exempt use. Property’s use must be an 
integral part of the exempt organization’s operations, not just a convenience, and reasonably necessary for the proper and 
efficient fulfillment of the organization’s exempt purpose. 
 
ACTUAL USE: Property must be actually used for a permitted or qualifying use pursuant to the statute under which exemption 
is sought. Future use; for-profit use; and private use are ineligible. Occasional, incidental nonexempt use does not in itself 
invalidate exemption. 
 
PARTIAL (PRORATED) USE v. EXCLUSIVE USE: Whether a property must be used solely or exclusively for its exempt 
purpose or if a proration is permitted depends upon the statutory language specific to that organization. For instance, schools, 
hospitals, religious and charitable organizations allow prorated exempt/taxable use while volunteer first-aid squads and 
associations to prevent cruelty to animals must meet the exclusive or singular use criteria. Please review applicable statute. 
 
NONPROFIT STATUS: Federal 501(c)(3) status is not controlling with respect to New Jersey property tax exemptions. A 
monetary surplus, rather than a loss, does not necessarily indicate a for-profit, commercial operation. Provided moneys go back 
into operation of exempt organization, exemption is permissible. However, a for-profit motive, as evidenced by the facts, 
invalidates exemption, i.e., is the organization’s structure, financial agreements, tuitions, fees set etc. with the intent to make a 
profit. 
 
DOCUMENTARY PROOFS: N.J.S.A.54:4-4.4 provides, Each assessor may at any time inquire into a claimant’s right to 
continue an exemption and for that purpose he may require the submission of such documentation as he considers necessary to 
determine the claimant’s continuing right to exemption. Claimants may be asked to provide: proof of income via audited 
financial statements, tax return copies; proof of ownership via deed; proof of use via lease/rental agreements, itinerary/calendar 
of events & organization’s promotional literature; proof of organization’s purpose via certificate of incorporation, articles of 
association, charter or mission statement, and constitution and by-laws. 
 
   Burden of proof is on exemption claimant; it is not the responsibility of the assessor to seek out claimant or to bring 
                                                      claimant into exemption compliance. 
 
STATUTES: Veterans organizations                                                           N.J.S.A54:4-3.5 & 54:4-3.25 & 54:4-3.15
                       Educational, religious, charitable organizations                                                    N.J.S.A.54:4-3.6 
                       Firefighter organizations                                                         N.J.S.A.54:4-3.10 & 54:4-3.13 
                       Burial grounds & cemeteries                                                 N.J.S.A.54:4-3.9 & N.J.S.A.8A:5-10 
                       Youth organizations                                                                               N.J.S.A.54:4-3.24 
                       Fraternal organizations                                                                           N.J.S.A.54:4-3.26 
                       Disaster relief organizations                                                                     N.J.S.A.54:4-3.27 
                       District Supervisor Religious Organization                                                        N.J.S.A.54:4-3.35 
                       Historic Sites                                                                                    N.J.S.A.54:4-3.52 
                       Conservation/Recreation Land                                                                      N.J.S.A.54:4-3.64 
 
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. 
 
DENIALS/APPEALS: Any unfavorable determination by the assessor may be appealed to the County Board of Taxation 
annually on or before April 1. 
                                                      FOR ASSESSOR USE ONLY 
        !  Deed/Ownership Documents                              !          Lease/Rental Agreements
        !  Insurance Policy on Property                          !          Certificate of Incorporation
        !  Articles of Association                               !          Constitution and By-laws
        !  Audited Financial Statements                          !          Tax Returns
        !  Charter and/or Mission Statement                      !          Organization’s Promotional Literature
        !  Itinerary/Calendar of Events                          !          Addendum containing any other pertinent information 






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