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 Application for Property Tax Exemption
                           Application for Property Tax Exemption
                           (RCW 84.36)
                                                                                          Reset form
                           See page 6 for complete instructions and 

Form 63 0001               general information.                                            Print form
                                                                                           
Department of Revenue use only

Post/email:                                     Scan:                             Fee:                  

Registration number:                                     County number:                                 

1 Applicant organization information

Name:                                                                                                   

Mailing address:                                                                                        

City:                                                    State:             Zip:                        

Contact person:                                          Phone:                                         

Website:                                               Email:                                           

UBI number:                        Federal Employer Identification Number:                              
Does your organization currently have a property tax exemption on any property in Washington? 

           Yes      No       Unknown  If yes, what is your registration number? 

Is your organization currently exempt from federal income tax under 501(c)?        Yes        No 

2 Property information

County:                                                  
I am claiming exemption for (check all that apply):
         Real property tax (building and land)                           Owned             Leased
         Personal property tax (furnishings and equipment)               Owned             Leased
         Leasehold excise tax (lease of government owned property)                               Leased

       Government owner/lessor:                                                                         

Name of site occupant (if different from applicant):                                                    

Site location address:                                                                                  

City:                                                   State:               Zip:                       
Parcel numbers:                                                                                                              
State the current and/or planned use of the property: 

 1.   On what date did your organization purchase/lease this property? 

 2.   On what date did your organization begin to conduct the exempt activity at this location? 

To request this document in an alternate format, please complete the form  
dor.wa.gov/AccessibilityRequest or call 360-705-6705. Teletype (TTY) users please dial 711.
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 Application for Property Tax Exemption

 3. Was this property exempt to the previous owner or lessee?     Yes         No             Unknown

 4. Does your organization rent/sublease the property or a portion of the property?    Yes        No 
 5.  Does your organization rent/loan the property to individuals or groups for events or meetings?

     Yes                    No        
           If yes, please provide a list of renters and fees:  

 6. Does this property include a parsonage, convent, or caretaker residence?  Yes            No 

 7. Are any buildings under construction,  remodel, or          planned to be built?   Yes          No 

    If yes, what is/was the start date?                          

    When is the estimated completion date?                        

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Application for Property Tax Exemption

3 Exemption matrix
Please use the checkbox to identify the exempted activity under which you are applying. 

                                                        Rule                                                    Rule 
                                                Statute                                               Statute 
                                                        WAC                                                     WAC 
Exempt activity or use                          RCW            Exempt activity or use                 RCW 
                                                        458-                                                    458-
                                                84.36                                                 84.36
                                                        16-                                                     16-
  Administrative offices of a religious org.    032            Income qualifying households*          560       560
                                                                Rental housing facility
  Agricultural research or education facility   570
                                                                Future housing facility or cooperative
  Artists – Property used to solicit or collect 650
                                                                Mobile or manufactured home 
money for artists                                              cooperative
  Blood/Tissue bank                             035             Library (open to the public & free)*  040       260
  Cancer clinic or center                       046             Limited equity cooperative housing    675
  Cemetery*                                     020(1)  180     Military housing facility             665
  Church building                               020(2)  190,    Museum                                060(1)(a) 280
                                                        200
  Future church site (land only) *                              Future museum site*
  Parsonage/Caretaker res.*                                     Nature conservancy land*              260, 262  290
  Convent*                                                      Nonprofit hospital*                   040       260
  Church camp*                                  030(2)  220     Public hospital* (leased property)
  Community celebration facility*               037     310     Outpatient dialysis facility*         040       260
  Community center (surplus school              010             Performing arts facility              060(1)(b) 282
district property)                                              Future performing arts facility*
  Consul office/residence                       010(1)          Public assembly hall or meeting       037       300
                                                               facility*
  Child day care center*                        040(1)(a) 260
                                                                Rebroadcast government radio/TV       047
  Emergency/Transitional/Recovery               043     320
                                                               signal
housing facility*
                                                                Senior citizen center                 670
  Fair association*                             480
                                                                School or college*                    050       280
  Federally incorporated relief organization    030(5)
                                                                College foundation                    050       280
  Fire company                                  060(1)(c) 284
                                                                Sheltered workshop for the            350       330
Home for the aging*                             041     A-010  handicapped
  HUD financed facility                                 A-020                                         030(1)    210
                                                                Social service organization*
  Tax exempt bond financing                                                                           240
                                                                Soil/Water conservation district
  Non-HUD or bond: income verification                                                                550       215
                                                                Solicitation & distribution of gifts, 
  Home for the developmentally disabled*        042            donations, or grants*
  Home for the sick or infirm*                  040     260     Student loan agency                   030(6)    245

  Homeownership development                     049             Veteran’s organization*               030(4)

  Humane society                                060     286     Water distribution organization*      250

                                                                Youth character building organization 030 (3)   230
                                                               (18 or younger) *
                                                               
                                                              *Additional documents are required. Please see 
                                                              Section 6.
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Application for Property Tax Exemption

4 Documentation confirmation
Check the box to indicate that the following required documentation is included with this application 
packet. Incomplete applications cannot be processed and will be returned.

  A copy of your IRS letter, only if your organization has been granted exemption from federal income 
 tax under section 501(c).

  A copy of the ownership deed for real property or a copy of the lease agreement, if the property 
 is being leased. Note: Do not submit a Deed of Trust, as it is a financing document and does not 
 demonstrate ownership. Please submit a Warranty, Quit Claim, Bargain and Sale, or similar deed to 
 document ownership.

  All additional documents listed in Section 6 of this application for the activity/exemption claimed.*

  If your organization rents/sub-leases the property or a portion of the property, please provide the 
 following:
           • A copy of all rental/sub-lease agreements, use agreements, or occupancy agreements.

  If your organization rents or loans the property or a portion of the property for meetings, parties, 
 or similar events, for more than 15 days in a calendar year, please provide the following:
           • A copy of your rental policies and rates.
           • A list of all individuals or organizations that used/rented from you during the previous 
             calendar year. The list must include the dates your property was used, the name of the user, 
             the purpose for which the property was used, the amount of rental/donation received, 
             duration/hours of use, and whether the function was open to the public.
           • Maintenance and operation expenses attributed to the rental space.

5 Certification and refund request
By signing this document, I certify that I am an authorized representative of the applicant. I certify that 
the statements in this application and the information attached are true and correct to the best of my 
knowledge and belief, and are made for the purpose of having the property described here on or a part 
thereof, exempt from taxation. I certify that I have reviewed, and can produce upon request, a statement 
of the receipts and disbursement of the applicant which shows that the income and receipts (including 
donations) have been applied to the actual expenses of operating and maintaining the exempt activity 
or for its capital expenditures and to no other purpose. If applicable, I request a refund of property taxes 
under the provisions of RCW 84.36.815 and RCW 84.69.020 and RCW 84.69.030.

Signature:                                                                Date:                                 

Print name:                                            Title:                                                 

Phone:                             Email:                                                                     

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Emergency/Transitional housing facility - Please
6 Additional documents required provide:
In addition to the documents requested in section 4, • A description of your program or a list of the
you must also provide the documents listed for your supportive services provided by your organization.
specific activity. • A copy of your length of stay policy.
• A copy of your tenant agreement.
Cemetery (nonprofit & for-profit) - Please provide: • A tenant list showing names of occupants, their
• A copy of the cemetery plat or map. move- in/move-out dates, and the rental fee.
• A copy of your cemetery license issued by the • Maintenance/operation expenses of the housing
Department of Licensing. facility.

Registered Recovery Residences - Please provide:
Future church site - Please provide:
• Documentation demonstrating your registration with
• Clearly established plans for financing the
the Washington State Health Care Authority as an
construction.
approved recovery residence.
• The proposed architectural plans showing what
• Tenant list with rental rates.
portion of the property will be under actual exempt
• Maintenance/operation expenses of the residence.
use.
• A copy of your site survey, building permit, other Fair association - Please provide:
documents relevant to confirming an active building • Documentation demonstrating your organization
program. sponsors a fair, which receives support from the
Department of Agriculture Fair Fund.
Parsonage - Please provide documentation
confirming: Home for the aging HUD assisted facility - Please
• The occupant is a licensed or ordained member of provide:
the clergy. • A listing of the varying levels of care and supervision
• The occupant is responsible for holding regularly provided or coordinated by the home.
scheduled worship services. • Documentation demonstrating the facility is assisted
by a HUD Project Based Program.
Convent - Please provide documentation confirming: • A residential tenant list showing the unit number;
• The occupants are licensed or ordained members of name of the resident(s) occupying the unit as of
clergy devoted to religious life under a superior (i.e. January 1, age of resident(s), an indication if the
convent formation document and resident guide). resident is disabled; the annual household income,
and a description of the assisted living services (if
Caretaker residence - Please provide: provided).
• A copy of your caretaker’s contract/occupancy
agreement. Home for the aging non-HUD or bond financed
• A list of your caretaker’s duties.
facility (Income Verified) - Please provide:
• A listing of the varying levels of care and supervision
Child day care center - Please provide:
• A copy of your Child Care license from the provided or coordinated by the home.
• A completed Tenant List Template showing the unit
Department of Early Learning.
number; name of the resident(s) occupying the unit
Church camp - Please provide: as of January 1 of the current year, age of resident(s),
• A list of all groups, organizations, or individuals an indication if the resident is disabled; the annual
(including your organization) that used the facility household income, and a description of the assisted
during the previous calendar year. This information living services (if provided).
should contain the dates of use, name of the user, the • Applicant must also file an income verification form
activities provided or conducted, and the rental or REV 64 0043 with their County Assessor’s Office for
donation amount received. each eligible resident.

Community celebration facility - Please provide: Home for the aging tax exempt bond financed facility
• Documentation confirming the property has been Please provide:
primarily used to conduct an annual community • A listing of the varying levels of care and supervision
celebration event for 10 or more years. provided or coordinated by the home.

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• A copy of the regulatory agreement between the Limited equity cooperative housing - Please
home and the entity that issued the bonds. provide:
• A residential tenant list showing the unit number; • Copy of agreements/documents that define the
name of the resident(s) occupying the unit as of applicant’s interest in the ownership and operation
December 31 of the previous year, age of resident(s), of the owned cooperative housing, including sale
an indication if the resident is disabled; and the restrictions (i.e. formation/ownership structures,
annual household income. operating agreements, regulatory agreements, etc.).
• Site plan demonstrating at least 95% of the property
Home for the developmentally disabled - Please is used for dwelling units or other noncommercial
purposes.
provide:
• A tenant listing showing the names of all occupants, • A tenant list showing the unit number, name of
and move-in dates. occupant as of January 1 of the assessment year,
• Proof of tenant eligibility (provided by DSHS – or the first date of occupancy in the first year of
operation, annual household income, and number of
Division of Developmental Disabilities).
occupants in each unit.
• Documentation confirming the housing is insured,
Home for the sick or infirm - Please provide:
• A copy of the facility’s license issued by the financed, or assisted through one of the following
sources:
Department of Health.
Ê A federal or state housing program
Housing facilities or mobile/manufactured home administered by the Department of
Commerce.
cooperatives with income qualifying households
Ê A federal or state housing program
(existing or future) - Please provide: administered by the federal department of
• Copy of agreements that define the applicant’s
housing and urban development.
interest in the ownership and operation of the
Ê A federal housing program administered by a
facility/coop (i.e. formation/ownership structures,
city or county government.
operating agreements, regulatory agreements etc.).
Ê An affordable housing levy authorized under
• Documentation confirming the project was insured,
RCW 84.52.105.
financed, or assisted through one of the following
Ê The surcharges authorized by RCW 36.22.178
sources:
and 36.22.179 and any of the surcharges
Ê A federal or state housing program
authorized in chapter 43.185C RCW.
administered by the Department of
Ê The Washington State Housing Finance
Commerce.
Commission.
Ê A federal housing program administered by a
city or county government. Museum (future only) - Please provide:
Ê An affordable housing levy authorized by RCW • Clearly established plans for financing the
84.52.105. construction.
Ê Surcharges authorized by RCW 36.22.178 and • The proposed architectural plans showing what
36.22.179, or Chapter 43.185C RCW. portion of the property will be under actual use.
Ê Washington State Housing Finance • A copy of your site survey, building permit, other
Commission. documents relevant to confirming an active building
• A tenant list showing the type of unit, unit number, program.
name of the tenant occupying the unit as of
December 31 of the previous year, total number of Nature conservancy - Please provide:
tenants in unit, and their annual combined household • A description of the specific resource(s) preserved on
income. Not necessary to include for a future very the property.
low-Income housing facility. • A copy of your policy statement on the availability of
the property to the public.
Note: If applying as a future very low-income housing
facility then please provide a site map showing the facility Nonprofit or public hospital - Please provide:
to be constructed and a timeline of planned construction. • A copy of Department of Health Certificate of Need.
• A copy of Department of Health Construction Review
Library (free) - Please provide: Packet.
• A copy of your policies regarding use/membership, • A copy of Department of Health Hospital Acute Care
library hours, and material loan. License for the address under application.
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Application for Property Tax Exemption

Outpatient dialysis facility - Please provide: Gift and giving example:
Number of Reduced by
• A copy of your license issued by the Department Cost
clients at least 20%
of Health.
Uninsured Free 81 12.52%
Performing arts facility (future only) - Please provide: Medicaid 80 12.36%
• Clearly established plans for financing the Medicare 22
construction. Private insurance 412
• The proposed architectural plans showing what
Total clients: 647 *24.88%
portion of the property will be under actual
exempt use. *Because this amount is greater than 15%, it would qualify for the exemption.

• A copy of your site survey, building permit, other Note: Instead of providing items 2 & 3 above
documents relevant to confirming an active you may submit documentation confirming your
building program. organization contributed at least 10% of the total
annual income received from the property under
Public assembly hall/meeting facility - Please
application towards the support of social services.
provide:
• A copy of the facility’s rental policies and rates. Solicitation of gifts, donations, or grants for
• Samples of public advertisement concerning the nonprofits - Please provide:
rental facility. • Proof of your affiliation with a state or national
• A list of individuals/groups that used your facility volunteer charitable fund-raising organization.
during the previous calendar year including uses • A list of the organizations receiving gifts, grants,
by your organization. The list must include the or donations from your organization.
dates the property was used, the hours/duration
of each use, the names of the user, the purpose Veteran’s organization - Please provide:
for which the property was used, and the • A copy of your organization’s national charter
amount of rental/donation received. document.

School or college - Please provide: Water distribution organization - Please provide:
• Documents which show accreditation by • A list of members and their addresses.
the Superintendent of Public Instruction or • A list showing addresses receiving water.
certification by an external agency that certifies
educational institutions such as the U.S. Youth Character Building Organization
Department of Education. Please provide:
• A copy of course catalog, schedule, and student • A copy of your policy statement that shows the
handbook. maximum age of participants served by your
organization.
Social Service Organization - Please provide:
• A general description of the goods/services
provided. 7 Submittal instructions
The attached application is used by nonprofit
• A copy of your sliding fee scale or other charity
organizations seeking exemption from real property
care/reduced fee schedule or policy.
tax, personal property tax and leasehold excise tax (a
• A spreadsheet showing the total number of
tax on the use of government owned property).
clients served at the location during the previous
1. Read the entire form.
year categorized by primary payer (see example).
2. Review the table on page 2 and select the
exemption that best fits your organization’s
activities.
3. Compile or prepare the documents requested in
sections 4 & 6 of this application.
4. Complete Sections 1, 2 and 3 of the application.

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Application for Property Tax Exemption

5. Scan and email the completed application form the Board within 30 calendar days of the date the
along with the additional documentation to: determination was mailed or emailed. You must
dornonprofitapplication@dor.wa.gov or send by allow for mailing time within the 30 day period. To
U.S. mail to: obtain an appeal form, call the Board at 360-753-
Department of Revenue 5446 or visit their website at www.bta.state.wa.us.
Property Tax Division/Exempt Property
PO Box 47471 Annual renewals due March 31
Olympia WA 98504-7471 To keep your property tax exemption, you are
required to submit an annual renewal. The
Department of Revenue (department) sends a notice
each year in January, reminding nonprofits to renew
8 General information
their exemption online (www.dor.wa.gov) prior to
Nonprofit organizations, even though they may be
the March 31 deadline. The renewal process cannot
exempt from federal taxes, are not generally exempt
be used to add property to an existing exemption.
from property taxes in Washington state. Unless
Organizations wanting to add previously taxed
the nonprofit organization is exclusively using the
property to an existing exemption must submit a
property to conduct an activity specifically exempted
new application.
by the Legislature, it is required to pay property
taxes in the same manner as other entities. The Report changes in use
exempt activities are found in Chapter 84.36 of After the exemption has been granted, any change in
the Revised Code of Washington (RCW). Additional use or ownership must be reported to the Property
information regarding these exemptions is located Tax division of the Department of Revenue within 60
in Chapter 458-16 of the Washington Administrative days of the change.
Code (WAC). A helpful reference matrix is included
with this application. Jeopardizing the exemption
Washington’s laws and rules restrict the manner in
Ownership which exempt property may be used. To qualify for
Generally, ownership by a nonprofit entity is and maintain exempt status the property must be
required to qualify for exemption. However, some exclusively used to conduct the exempted activity.
statutes allow nonprofit organizations to lease All other activities including commercial activities
property and remain eligible for exemption. In these must be severely restricted. Property may be
cases the lease must transfer the responsibility for exempt in part if a portion of the property does not
the property taxes to the nonprofit. initially qualify, or fails to continue to qualify for the
exemption.
Filing date
Applications are due within 60 days of acquiring
Tax rollback
the property and/or converting the property to an When an exempt property is no longer used for the
exempt use. Applications requesting a retroactive purpose under which an exemption was granted,
exemption are accepted as long as the application is and has not been exempt for the required number
filed within three years of the date the taxes were of years, the property may be subject to rollback
due. Late or retroactive applications are subject to provisions. This means taxes, plus interest, may
late filing penalties. be assessed for the current year plus the three
previous years. There are several exceptions to this
Appeal process
rule. Please contact the Department of Revenue’s
After the department reviews your initial application
Property Tax division for more information.
and/or renewal, they will issue a determination of
taxability. If you do not agree with the Department
For assistance or questions on this form
of Revenue’s determination, you have the right Please contact the Exempt Property Tax section of
to appeal to the Washington State Board of Tax the Department of Revenue at 360-534-1400.
Appeals (Board). Your appeal must be filed with

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