Chapter 84.36 RCW
Instructions are located at the end of this application
This Section is for Department of Revenue Use Only
Section 1 - Applicant Information
(Church or Nonprofit conducting the exempt activity and claiming the exemption)
Street or PO Box
Has your organization been issued a Tax Registration Number or Unified Business Identifier by the State of Washington?
Unknown If yes, what is your TRN/UBI number?
Does your organization currently have a property tax exemption on any property in Washington?
Unknown If yes, what is your registration number?
Is your organization currently exempt from federal income tax under 501(c)?
Section 2 – Property Information
I am claiming exemption for: (Check all boxes that apply)
Real Property (building & land)
Personal Property (furnishings & equipment)
Leasehold (lease of government owned property)
Street or PO Box
Please use a separate application if parcels are not contiguous, adjacent, or part of a larger campus/site
Describe the activity conducted on or using this property and state the name of the occupant if different than applicant.
1. Was the property exempt to the previous owner or lessee?
2. Does your organization allow other individuals or organizations to rent/use this property?
3. Does the property include a
4. Are any buildings planned or under construction?
If yes, what is/was the start date?
What is the estimated completion date?
To ask about the availability of this publication in an alternate format, please call 1-800-647-7706. Teletype (TTY) users may use the Washington
Relay Service by calling 711. For tax assistance, call (360) 534-1400.
REV 63 0001 (11/5/13)
Section 3 – Late Filing Penalty
Please state the penalty fee* (if any) enclosed with this application:
1. On what date did your organization acquire (purchase/lease) this property?
2. On what date did your organization begin using this property to conduct the exempt activity?
Applications postmarked within 60 days of the acquisition or conversion date do not require a late fee. Applications filed after this due date are subject to a late filing penalty. Please see the attached instructions regarding late fee calculation, or call (360)
534-1400 for assistance.
Section 4 - Documentation Confirmation
Do not staple this application or submit stapled documents
Please indicate the following required documentation is attached to this application:
Copy of your Articles of Incorporation showing the stamp of the Secretary of State (include all amendments)
Churches Only: May submit a copy of their Bylaws or Faith Statement instead of stamped articles.
Copy of your IRS letter, if your organization has been granted exemption from federal income tax under section 501(c)
Copy of your most recent IRS Form 990 OR a copy of your most recent income and expense statement*
*Financial information is not requested of Churches
For the property claimed please indicate the applicable required documentation is attached to this application:
A copy of the deed for real property or a copy of the lease agreement if the property claimed is leased.
Note: A “Deed of Trust” cannot be used to demonstrate ownership. Please submit a warranty, quit claim, or similar deed.
Parcel map and legal description (This information can be obtained from your County Assessor’s office or their website.)
Site plan which identifies the location of buildings, parking, landscaping, and undeveloped areas.
Pamphlets, brochures, and/or letter explaining the function of the occupant and