Affidavit Concerning Personal Property Use · Affidavit Concerning Personal Property Use BEFORE ME,...
Transcript of Affidavit Concerning Personal Property Use · Affidavit Concerning Personal Property Use BEFORE ME,...
THE STATE OF TEXAS Harris County Appraisal District
COUNTY OF HARRIS Account Number
Tax Year
Affidavit Concerning Personal Property UseBEFORE ME, the undersigned authority, on this day personally appeared __________________________ known to me, and who
being by me duly sworn, on oath deposed and said:
"I testify that the following personal property items:
listed in the name of _____________________________________________________________________ a nonprofit
organization, and situated at _____________________________________________________ are not held or used for the
production of income."
"I further testify that for the tax year indicated above: (a) none of the above listed items have been or will be reported to the Internal
Revenue Service as a depreciable business asset or as an asset on which a mileage rate was or will be claimed in lieu of depreciation;
(b) no maintenance, repair, fuel, insurance, or other costs for any of the above listed items have been or will be charged off or claimed
as a business expense for federal income tax purposes; and (c) none of the above items are used in a way that results in accrual of
distributable profits or realization of private gain."
SUBSCRIBED AND SWORN TO before me this the ________ day of _____________________, _________.
INH:AFF:002 (6/10)
Item Item
Exempt item listing continued next page
Affiant's Signature
Typed or Printed Name
Title
Organization Name
IRS Identification Number
Notary Public, State of Texas
address
My Commission Expires