TAX ABATEMENT APPLICATION

(Commercial/Industrial)

Application is for abatement of real property taxes assessed January 1, 2008, accruing
July 1, 2008 through June 30, 2009, on real property destroyed by flood. The destroyed
real property cannot have been sold for taxes or have taxes delinquent for 30 days as of
June 13, 2008.

The term “destroyed” as used in this abatement program shall mean, in the case of
commercial or industrial property, a significant loss of the use and enjoyment of the real
property as evidenced by a loss of use of all mechanical systems and inability to utilize
the property for business purposes for a period of time. The abatement shall be granted
only for that portion of the real property destroyed as above defined.

The applicant must have been the legal title holder on June 13, 2008 and continues to hold
legal title to the destroyed real property.

The deadline for submitting this application will be October 1, 2009 at 5:00 p.m. Late
applications will only be accepted for good cause shown

Hand Delivered Address:

Linn County Treasurer
Lower Level
2500 Edgewood Road SW
Cedar Rapids, Iowa

Mailing Address:
Linn County Treasurer
930 First Street SW
Cedar Rapids, IA 52404

For questions please call (319) 892-5000

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1. Applicant’s Name:
2. Applicant’s Address:

3. Applicant’s Phone Number:

4. Address of property for which tax abatement is requested:

5. Parcel number or GPN of property for which tax abatement is requested:

6. January 1, 2008, assessed value of property for which tax abatement is requested:

7. January 1, 2009, assessed value of property for which tax abatement is requested:

8. Describe in detail the nature and extent of physical damage to the property for which
tax abatement is requested, including damage to mechanical systems and appliances:

9. Describe in detail the extent and duration during the period July 1, 2008 through June 30,
2009 that tenants or other business occupants were displaced from the property for which tax
abatement is requested.
10. What is the cost of repair, estimated or actual, of the real property for which tax
abatement is requested?

11. At the time of the loss, who held legal title to the property?

12. Who currently holds legal title to the property?

13. Has this property been sold for taxes? ____Yes ____No

14. As of June 13, 2008 were the taxes on the property delinquent for 30 days or more?
____Yes ____No

15. Has any portion of your property taxes been paid or paid into escrow by private insurance or
public assistance? ____Yes ____No

If yes, what amount was paid by private insurance or public assistance? __________________

I hereby make application for abatement of real property taxes assessed on the real property listed above
assessed January 1, 2008, accruing July 1, 2008, to June 30, 2009, and payable September 30, 2009 and
March 31, 2010, and swear upon oath that the information contained in this application is true and
correct as I verily believe. I understand that providing false information on this application may result in
criminal prosecution.

Date Applicant

Subscribed and sworn to before me this______________ day of ___________________ , 2009.

Notary Public