Fill and Sign the Standard Interrogatories to Be Served on Taxpayers for Form

St andard I nt errogat ories t o be Served on Taxpayer for Exempt ion Cases Rev. 05/2006, CN 10968-English page 1 of 2 Answ er as of Oct ober 1st of t he pret ax year 1. St at e t he name and address of t he t a xpayer claiming exempt ion f rom t axat ion ( hereinaf t er ref erred t o as t he " t axpayer" ) . 2. Set f ort h t he st at e in w h ich t he t axpayer w as incorporat ed or organized, t he dat e of incorporat ion or organizat ion, and t he st at ut e or law under w hich t axpayer w as incorporat ed or organized. I f t he t axpayer is a f oreign corporat ion or associat ion, set f ort h t he dat e of regist rat ion in t he Of f ice of t he New Jersey Secret ary of St at e. 3. At t ach a copy of t he t axp ayer's Cert if icat e of I ncorporat ion, Art icles of Associat ion and/ or Corporat e Chart er and By -Law s. I nclude all amendment s. 4. St at e in det ail t he basis f o r t he t axpayer's assert ion t hat t h e subj ect propert y is ent it led t o t ax exempt ion. This st at ement should include, but not be limit ed t o, a specif icat ion as t o t he st at ut e at issue, t he part ic ular sect ion of t he st at ut e on w hich t he t axpayer is relying, and t he f act s w hich lead t he t a xpayer t o believe it is ent it led t o exempt ion under such st at ut e. 5. Provide copies of t he t axp ayer's f inancial st at ement s f or t he year of appeal and t he preceding t w o years. 6. Describe in det ail all f und raising act ivit ies perf ormed by or on behalf of t he t axpayer during t he t ax year at issue and t he preceding t w o ( 2) years. I nclude a descript ion of each t ype of f undraising act ivit y, t h e income generat ed by t he act i vit y, and t he manner in w hich t he income w as dist ribut ed and used. 7. St at e whet her t he t axpayer is exempt f r om f ederal income t ax under I RC §501( c) ( 3) . I f so, provide copies of all docu ment at ion sent t o or received f rom any government ent it y concerning t his exempt st at us. 8. St at e whet her any of f icer or ot her pe rson or ent it y receives any compensat ion, allow ance or pecuniary prof it f rom t he t axpayer. I f so, explain t he reason or basis f or payment of such compensat ion, allow ance or prof it , st at e t he name and t it le of each such of f icer, person or ent it y, and, as t o each, set f ort h t he amount of compensat ion, allow ance, and prof it . 9. Set f ort h t he names and addresses of t a xpayer's board of direct ors and corporat e of f icers. 10. For t he t ax year under appeal and each of t he preceding t w o years, st at e t he manner in w hich t he surplus income generat ed by t h e subj ect propert y w as dist ribut ed, t he name and address of each pers on or ent it y t o w hich a dist ribu t ion w as made, and t he amount of each dist ribut ion. 11. St at e dat e t he t axpayer acquired t he subj ect propert y. St andard I nt errogat ories t o be Served on Taxpayer for Exempt ion Cases Rev. 05/2006, CN 10968-English page 2 of 2 12. St at e name in which t it le t o t he subj ect propert y is vest ed. 13. Describe t he subj ect propert y, including land area, and whet her land is improved or vacant . I f t he land is vacant , sp ecif y land use, if any. I f t he land is improved w it h buildings, st ruct ures or ot her f acilit ies, describe in det ail each such bu ilding, st ruct ure or f acilit y, including square f oot area, number of f loors, and use. 14. Describe in det ail each use t o w hich t he subj ect propert y w as put f or t he t ax year under appeal and each of t he pr eceding t w o years, w het her or not such use is t he basis f or t he t axpayer's claim of ex empt ion. I nclude in such descript ion t he f ollow ing: ( a) a det ailed list of t he services pr ovided or perf ormed at t he propert y; ( b) w het her any business w as conduct ed on or at t he propert y, and, if so, describe such business; ( c) t he area or port ion of t he propert y in or at w hich such use t ook place; 15. St at e w het her any part of t he land or building f or w hich t axpayer seeks exempt ion w as rent ed, leased or used or occupied by any person, corp orat ion or ent it y ot her t han t he t axpayer. I f so, set f ort h as t o each t enant , occupant or user: ( a) name and address, ( b) t he port ion of t h e propert y leased, occupied or used, ( c) t he annual income derived f rom su ch t enancy, occupancy or use, and ( d) t he use by such t enant , occupant or user. Provide a copy of all writ t en le ases and ot her agreement s relat i ng t o occupancy or use, and describe in det ail any agr eement not in w rit ing. CERTI FI CATI ON I hereby cert if y t hat t he f oregoing st at ement s are t rue and t hat all document s and report s annexed heret o are exact copies of t he ent ire original document or repo rt . I am aw are t hat if any of t he f oregoing st at ement s made by me are w illf ully f alse, I am subj ect t o punishment . Dat ed: ____________________ By: _____________________________________