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Application And Affidavit For Religious Organizations

2. APPLICATION AND AFFIDAVIT
   This application and affidavit is to be used by organizations seeking property tax exemption pursuant to Section 170 of the Kentucky Constitution. Answer all questions as fully as possible.

   This application and affidavit is to be used by organizations seeking property tax exemption pursuant to Section 170 of the Kentucky Constitution. Answer all questions as fully as possible.

4. This application and affidavit is to become an integral part of the Application for Exemption from Property Taxation currently on file with the Kenton PVA office and to be used only for those entities seeking exemption on additional property(ies) originally not included and approved as part of the entity’s application for exemption.

6. Entity Name*

   Enter Exact Legal Name of Organization

7. Email Address

9. Property Location*

   Number and Street

11. City*
    -- Select One --BromleyCovingtonCrescent Springs Crestview Hills EdgewoodElsmereErlangerFairviewFt. Mitchell Ft. Wright IndependenceKenton ValeLakeside Park LudlowPark HillsRyland Heights Taylor Mill UnincorporatedVilla Hills Walton

12. State*
    -- Select One --ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYPR

13. Zip Code*

15. Phone Number

16. Fax Number

18. Parcel IDentification Number (PIDN) if known

    as it is printed on your tax bill (e.g. 001-01-23-456.78)

20. Purpose of the Organization and Major Activity of Applicant

22. Describe the current use of the property above.

    Indicate whether any rents or income is received for this property and if so, the amount(s).

24. Petitioner's Agreement to Authorization of Inspection and Affidavit of Authority:*

    For this property tax exemption application, I authorize the Department of Revenue (DOR) or its representative(s) to visit and inspect the property to be exempted now and in the future, to ensure the property is being used for tax exempt purposes. I hereby certify that the statements and information contained herein are correct to the best of my knowledge and belief and that I am authorized to sign this application. All other information submitted as part of the original application that would impact the PVA’s or Department of Revenue’s decision in granting exemption remain the same.

    1. I Agree
28. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
30. Electronic Signature*

    Applicant Authorization and Signature

31. Signed Date*
    Signed Date

33. Title of applicant

37. To be Completed by the PVA Office

    Recommendation

39. <script> /******************************************************* * create a filter that will be used to determine * which keystrokes are allowed in the input field * and which are not. Since we're working exclusively * with phone numbers, we'll need the following: * -- digits 0 to 9 from the numeric keys * -- digits 0 to 9 from the num pad keys * -- arrow keys (left/right) * -- backspace / delete for correcting * -- tab key to allow focus to shift *******************************************************/ var filter = []; //since we're looking for phone numbers, we need //to allow digits 0 - 9 (they can come from either //the numeric keys or the numpad) const keypadZero = 48; const numpadZero = 96; //add key codes for digits 0 - 9 into this filter for(var i = 0; i <= 9; i++){ filter.push(i + keypadZero); filter.push(i + numpadZero); } //add other keys that might be needed for navigation //or for editing the keyboard input filter.push(8); //backspace filter.push(9); //tab filter.push(46); //delete filter.push(37); //left arrow filter.push(39); //right arrow /******************************************************* * replaceAll * returns a string where all occurrences of a * string 'search' are replaced with another * string 'replace' in a string 'src' *******************************************************/ function replaceAll(src,search,replace){ return src.split(search).join(replace); } /******************************************************* * formatPhoneText * returns a string that is in XXX-XXX-XXXX format *******************************************************/ function formatPhoneText(value){ value = this.replaceAll(value.trim(),"-",""); if(value.length > 3 && value.length <= 6) value = value.slice(0,3) + "-" + value.slice(3); else if(value.length > 6) value = value.slice(0,3) + "-" + value.slice(3,6) + "-" + value.slice(6); return value; } /******************************************************* * validatePhone * return true if the string 'p' is a valid phone *******************************************************/ function validatePhone(p){ var phoneRe = /^[(]{0,1}[0-9]{3}[)]{0,1}[-\s\.]{0,1}[0-9]{3}[-\s\.]{0,1}[0-9]{4}$/; var digits = p.replace(/\D/g, ""); return phoneRe.test(digits); } /******************************************************* * onKeyDown(e) * when a key is pressed down, check if it is allowed * or not. If not allowed, prevent the key event * from propagating further *******************************************************/ function onKeyDown(e){ if(filter.indexOf(e.keyCode) < 0){ e.preventDefault(); return false; } } /******************************************************* * onKeyUp(e) * when a key is pressed up, grab the contents in that * input field, format them in line with XXX-XXX-XXXX * format and validate if the text is infact a complete * phone number. Adjust the border color based on the * result of that validation *******************************************************/ function onKeyUp(e){ var input = e.target; var formatted = formatPhoneText(input.value); var isError = (validatePhone(formatted) || formatted.length == 0); var color = (isError) ? "gray" : "red"; var borderWidth = (isError)? "1px" : "3px"; input.style.borderColor = color; input.style.borderWidth = borderWidth; input.value = formatted; } /******************************************************* * setupPhoneFields * Now let's rig up all the fields with the specified * 'className' to work like phone number input fields *******************************************************/ function setupPhoneFields(idText){ var input = document.getElementById(idText); input.addEventListener("keydown", onKeyDown); input.addEventListener("keyup", onKeyUp); } //MAIN setupPhoneFields("e_8"); setupPhoneFields("e_9"); </script>

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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field