Application For Property Tax Exemption For Improvements
                       To Commercial And Residential Buildings
                                            N.D.C.C. ch. 57-02.2
                       (File with the city assessor or county director of tax equalization)

Property Identifi cation

 1.  Legal description of the property for which exemption is claimed _______________________________________

    ___________________________________________________________________________________________

 2.  Address of Property ___________________________________________________________________________

 3.  Parcel Number ________________________________

 4.  Name of Property Owner ________________________________________  Phone No.  ____________________

 5.  Mailing Address of Property Owner  ______________________________________________________________

Description Of Improvements For Exemption

 6.  Describe type of renovating, remodeling, alteration or addition made to the building for which exemption is
    claimed (attach additional sheets if necessary).  _____________________________________________________

  ____________________________________________________________________________________________

 7.  Building permit No. _____________________   8.  Year built (residential property)  ___________________

 9.  Date of commencement of making the improvements ____________________________

10. Estimated market value of property before the improvements       $  ____________________

  11.  Cost of making the improvement (all labor, material and overhead)  $  ____________________

  12. Estimated market value of property after the improvements      $  ____________________

Applicant's Certifi cation And Signature

  13. I certify that the information contained in this application is correct to the best of my knowledge.

      Applicant __________________________________________________________         Date  _____________________

Assessor's Determination And Signature

  14. The assessor/county director of tax equalization fi nds that the improvements described in this application

   do     do not   meet the qualifi cations for exemption for the following reason(s):  ________________________

    ___________________________________________________________________________________________

      Assessor/Director of Tax Equalization _________________________________      Date  _____________________

 Action Of Governing Body

15. Action taken on this application by the governing board of the county or city: Approved               Denied  
  Approval is subject to the following conditions: _____________________________________________________

    ___________________________________________________________________________________________

    Exemption is allowed for years 20___, 20___, 20___, 20___, 20___.
      Chairperson ________________________________________________________         Date  _____________________

24840  (Rev. 6-01)