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J~ORM PE- 1 CITY OF PORTSMOUTH REAL PROPERTY TAX EXEMPTION INFORMATION SHEET/APPLICATION OFFICE OF THE ASSESSOR t Do Not Write In This Space P. O. BOX 820, PORTSMOUTH, VIRGINIA 23705 Date Received fi-om Applicant DATE OF MAILING :J'! 'J'~"J REVISED JAN. '85 MAP.[9-~'~~'' P]k-I~CEL ~ .4-1 ~-) Initial:. Alt questions must be answered. If the question is, in fact, not applicable to your specific situation, place N.A. in place of answer. The form must be fully completed, signed and notarized. Failure to comply wilt result in the property not being considered for tax exempt status at this time. If the constitution and by-laws of your organization were previously sent to this office, and no amendments, etc, were added since that time, please indicate under proper question tl 1) and give date these items were sent. Please type or print and return the completed form within sixty (60) days of mailing date given above. ~ ~d~,,'~_~,( ¢.~/~(e.4~ ~v~.~.., ~.~-~'~ ~e'e-5~fl Owner/Name of Orgamza 'on: , t'~ .,t z~Z-~:~ .7. ~;-~':~1~, 4~t Location of Property: ,~.~?'b ~.~.. ~ ~'va- --- $ ~ 671 Present Value of Property Carried On Your Book: Land Improvements /~ .~ Total ,-Z .;L .~.~ O Are yon chartered incorp.or~d under the Laws of the Commonwealth of Virginia? Yes: ~"~o: 1. b. By what section°r of the Constitution 9 a. If yes, give date: / ~ ~"~'[ ~ / and Code of Virginia do you claim this exemption? "" For ~whatCrpose is the property being used? Please be specific. If there a(~e several types of,}ts~e2s,..~pno~n-~e, indicate by areas of_ the building ~nO floor.lqcafion. Al,s~i_ndic3a_te lal3d gr~g/a.s by'use or non-us~/ When w,.a hi property, originally acquired by your orgamzahon? ~ ~ &"~P ¥ Pr 5 42 Mo: r~ Yr. / ~' ~;~ O Land Area: ,~ ~ t~-~4 . . 4A. Has your organization acquire_d additional land since the date given under "4"? _ Yes: No: '~- Mo: Yr: as to land area, improvements thereon and specifiC- use as well as Map and 4B. Describe this additional acquisition Parcel Numbers. Deed Book and Page Number. ~1~ .,¢/ 5. Give dates of construction, etc., for the improvements located on your organization's properW, including additions, and renovations or demolitions and the value of same. Indicate specifically if these improvements are located on land arq~_cove~y "~' or "4A" abpv~e.__ .... t~, F) .~ ' ,~ ~ ~.. D /~ ~ -2~ ,~ 6. W~ an exemption previously ~ven this ~oup pumu~t to Article X, Sec. 6 (a) 6 of the Constitution of Vir~nia and listed ~ ~e Code of Vk~a Article IV, Chapter 36 of Title 58.17 I~.~, please cite ~e appropriate Acts of ~ Assemb~ wherein same was ~ven. Yes No ~ ¥. Does the o~hip group have an exemption under the Intern~ Revenue Code of 1954, Sec. 501 (c)? Yes: ~ No: ~X. If yes, ~ve date of Internal Revenue ruSng. ~ ¢ ~*~ ] ~ ~ 8. Do~ any other individual, ass~iation or co~oration occupy or use any pa~ of the premises? Yes: No: ~ .~. If yes, ~ve spedfic det~ls, t//~t