Nevada Pollution Control Affidavit Form

Transcript

AFFIDAVIT Claim for Property Tax Exemption of Pollution Control Facilities Under the Provisions of NRS 361.077 By: Owner of Facility ______ _____ Assessor ID# 99- Fiscal Year___________________ The types of property upon which tax exemption is claimed under this act consists of the following: DESCRIPTION OF PROPERTY PURPOSE LAWS OR REGULATIONS TO BE COMPLIED WITH INSTALLATION DATE INSTALLATION COST LOCATION I, , state on oath that the above claim for property tax exemption is made in good faith and is to the best of my knowledge and belief true, correct and complete and that the use of said property included in the above exemption claim is for the primary prim purpose of complying with laws for the prevention, control or reduction of air and water pollution. The property included in the above exemption claim is not used as: (1) an air conditioner, (2) a septic tank, or (3) a sewage facility used to move sewage to collection facilities. Each property or facility included in the above exemption claim does not produce a net profit to it itss owner or operator from the recovery and sale, or, use of a tangible product or byproduct, nor does such use result in a net reduction of operating costs. Further, I hereby authorize and empower Nevada taxing authorities author and their deputies to personally inspect the facilities, examine supporting documents or otherwise verify the above exemption claim(s). Subscribed and sworn to before me this _______ day of________________, 20_______. _____________________________________ Taxpayer or Authorized Representative ____________________________ Notary Public ADDITIONAL ATTACHMENT(S) DESCRIPTION OF PROPERTY Page _____ of ______ PURPOSE LAWS OR REGULATIONS TO BE COMPLIED WITH INSTALLATION DATE INSTALLATION COST LOCATION