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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             Library (open to the public & free) * 040      260
  Agricultural research or education facility   570             Limited equity cooperative housing    SB 5713
  Artists – Property used to solicit or collect 650             Military housing facility             665
money for artists
                                                                Museum                                060(1)   280
  Blood/Tissue bank                             035                                                   (a)
                                                                Future museum site*
  Cancer clinic or center                       046                                                   260, 262 290
                                                                Nature conservancy land*
  Cemetery*                                     020(1)  180                                           040      260
                                                                Nonprofit hospital*
  Church building                               020(2)  190,    Public hospital* (leased property)
                                                        200
  Future church site (land only) *                              Outpatient dialysis facility*         040      260
  Parsonage/Caretaker res.* 
                                                                Performing arts facility              060(1)   282
  Convent*                                                                                            (b)
                                                                Future performing arts facility*
  Church camp*                                  030(2)  220
                                                                Public assembly hall or meeting       037      300
  Community celebration facility*               037     310    facility*
  Community center (surplus school              010             Rebroadcast government radio/TV       047
district property)                                             signal
  Consul office/residence                       010(1)          Senior citizen center                 670
  Child day care center*                        040(1)(a) 260   School or college*                    050      280
  Emergency/Transitional housing facility*      043     320     College foundation                    050      280
  Fair association*                             480             Sheltered workshop for the            350      330
                                                               handicapped
  Federally incorporated relief organization    030(5)
                                                                Social service organization*          030(1)   210
  Fire company                                  060(1)(c) 284
                                                                Soil/Water conservation district      240
Home for the aging*                             041     A-010
  HUD financed facility                                 A-020   Solicitation & distribution of gifts, 550      215
                                                               donations, or grants*
  Tax exempt bond financing
  Non-HUD or bond: income verification                          Student loan agency                   030(6)   245

  Home for the developmentally disabled*        042             Veteran’s organization*               030(4)

  Home for the sick or infirm*                  040     260     Water distribution organization*      250

  Homeownership development                     049             Youth character building organization 030 (3)  230
                                                               (18 or younger) *
  Humane society                                060     286
                                                               
                                                              *Additional documents are required. Please see 
Income qualifying households*                   560     560
                                                              Section 6.
  Rental housing facility
  Future housing facility or cooperative
  Mobile or manufactured home 
cooperative

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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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celebration event for 10 or more years.
6 Additional documents required
In addition to the documents requested in section 4, Emergency/Transitional housing facility - Please
you must also provide the documents listed for your provide:
specific activity. • A description of your program or a list of the
supportive services provided by your organization.
Cemetery (nonprofit & for-profit) - Please provide: • A copy of your length of stay policy.
• A copy of the cemetery plat or map. • A copy of your tenant agreement.
• A copy of your cemetery license issued by the • A tenant list showing names of occupants, their
Department of Licensing. move- in/move-out dates, and the rental fee.
• Maintenance/operation expenses of the housing
Future church site - Please provide: facility.
• Clearly established plans for financing the
construction. Fair association - Please provide:
• The proposed architectural plans showing what • Documentation demonstrating your organization
portion of the property will be under actual exempt sponsors a fair, which receives support from the
use. Department of Agriculture Fair Fund.
• A copy of your site survey, building permit, other
documents relevant to confirming an active building Home for the aging HUD assisted facility - Please
program. provide:
• A listing of the varying levels of care and supervision
Parsonage - Please provide documentation provided or coordinated by the home.
confirming: • Documentation demonstrating the facility is assisted
• The occupant is a licensed or ordained member of by a HUD Project Based Program.
the clergy. • A residential tenant list showing the unit number;
• The occupant is responsible for holding regularly name of the resident(s) occupying the unit as of
scheduled worship services. January 1, age of resident(s), an indication if the
resident is disabled; the annual household income,
Convent - Please provide documentation confirming: and a description of the assisted living services (if
• The occupants are licensed or ordained members of provided).
clergy devoted to religious life under a superior (i.e.
Home for the aging non-HUD or bond financed
convent formation document and resident guide).
facility (Income Verified) - Please provide:
Caretaker residence - Please provide: • A listing of the varying levels of care and supervision
• A copy of your caretaker’s contract/occupancy provided or coordinated by the home.
agreement. • A completed Tenant List Template showing the unit
• A list of your caretaker’s duties. number; name of the resident(s) occupying the unit
as of January 1 of the current year, age of resident(s),
Child day care center - Please provide: an indication if the resident is disabled; the annual
• A copy of your Child Care license from the household income, and a description of the assisted
Department of Early Learning. living services (if provided).
• Applicant must also file an income verification form
Church camp - Please provide: REV 64 0043 with their County Assessor’s Office for
• A list of all groups, organizations, or individuals each eligible resident.
(including your organization) that used the facility
during the previous calendar year. This information Home for the aging tax exempt bond financed facility
should contain the dates of use, name of the user, the Please provide:
activities provided or conducted, and the rental or • A listing of the varying levels of care and supervision
donation amount received. provided or coordinated by the home.
• A copy of the regulatory agreement between the
Community celebration facility - Please provide: home and the entity that issued the bonds.
• Documentation confirming the property has been • A residential tenant list showing the unit number;
primarily used to conduct an annual community name of the resident(s) occupying the unit as of

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

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Application for Property Tax Exemption

• A copy of Department of Health Hospital Acute Care Gift and giving example:
License for the address under application.
Number of Reduced by
Cost
clients at least 20%
Outpatient dialysis facility - Please provide: Uninsured Free 81 12.52%
• A copy of your license issued by the Department
Medicaid 80 12.36%
of Health.
Medicare 22
Performing arts facility (future only) - Please provide: Private insurance 412

• Clearly established plans for financing the Total clients: 647 *24.88%

construction. *Because this amount is greater than 15%, it would qualify for the exemption.

• The proposed architectural plans showing what
Note: Instead of providing items 2 & 3 above
portion of the property will be under actual
you may submit documentation confirming your
exempt use.
organization contributed at least 10% of the total
• A copy of your site survey, building permit, other
annual income received from the property under
documents relevant to confirming an active
application towards the support of social services.
building program.
Solicitation of gifts, donations, or grants for
Public assembly hall/meeting facility - Please
nonprofits - Please provide:
provide:
• Proof of your affiliation with a state or national
• A copy of the facility’s rental policies and rates.
volunteer charitable fund-raising organization.
• Samples of public advertisement concerning the
• A list of the organizations receiving gifts, grants,
rental facility.
or donations from your organization.
• A list of individuals/groups that used your facility
during the previous calendar year including uses
Veteran’s organization - Please provide:
by your organization. The list must include the • A copy of your organization’s national charter
dates the property was used, the hours/duration document.
of each use, the names of the user, the purpose
for which the property was used, and the Water distribution organization - Please provide:
amount of rental/donation received. • A list of members and their addresses.
• A list showing addresses receiving water.
School or college - Please provide:
• Documents which show accreditation by Youth Character Building Organization
the Superintendent of Public Instruction or
Please provide:
certification by an external agency that certifies
• A copy of your policy statement that shows the
educational institutions such as the U.S.
maximum age of participants served by your
Department of Education.
organization.
• A copy of course catalog, schedule, and student
handbook.
7 Submittal instructions
Social Service Organization - Please provide: The attached application is used by nonprofit
• A general description of the goods/services organizations seeking exemption from real property
provided. tax, personal property tax and leasehold excise tax (a
• A copy of your sliding fee scale or other charity tax on the use of government owned property).
care/reduced fee schedule or policy. 1. Read the entire form.
• A spreadsheet showing the total number of 2. Review the table on page 2 and select the
clients served at the location during the previous exemption that best fits your organization’s
year categorized by primary payer (see example). 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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