Blank Dr 504 Florida PDF Form

Blank Dr 504 Florida PDF Form

The DR 504 Florida form is an application for ad valorem tax exemption designed specifically for nonprofit organizations. It allows entities such as charitable, religious, scientific, and literary organizations, as well as hospitals and nursing homes, to apply for tax relief on property used for exempt purposes. Completing this form accurately and submitting it on time is crucial for qualifying for the exemption.

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The DR-504 Florida form serves as a crucial tool for nonprofit organizations seeking an ad valorem tax exemption on properties used predominantly for charitable, religious, scientific, literary, or healthcare purposes. This application is specifically designed for entities such as hospitals, nursing homes, and homes for special services, allowing them to demonstrate their commitment to serving the community. To qualify, organizations must provide comprehensive information regarding their nonprofit status, the nature of property usage, and any financial dealings associated with the property. It is essential for applicants to complete the form accurately and submit it, along with required attachments, to the county property appraiser by March 1 of the current tax year. The form not only requires basic details such as the applicant's name and address but also necessitates documentation that verifies the organization's exempt status, financial condition, and operational records. By ensuring that all information is complete and truthful, applicants can help facilitate the review process, which is vital for securing the tax benefits that support their mission-driven activities.

Document Sample

AD VALOREM TAX EXEMPTION APPLICATION

AND RETURN FOR CHARITABLE, RELIGIOUS, SCIENTIFIC, LITERARY ORGANIZATIONS, HOSPITALS, NURSING

HOMES, AND HOMES FOR SPECIAL SERVICES

DR-504

R. 11/21

Rule 12D-16.002

FAC

Eff. 11/21

Page 1 of 3

Sections 196.195, 196.196 and 196.197, Florida Statutes

This application is for use by nonprofit organizations to apply for an ad valorem tax exemption for property used predominantly for an exempt purpose, as provided in sections (ss.) 196.195, 196.196, and 196.197, Florida Statutes (F.S.) (select all that apply):

Charitable Religious

Hospital

Nursing Home

Scientific Literary

Homes for Special Services

This completed application, including all required attachments, must be filed with the county property appraiser on or before March 1 of the current tax year.

General Information (All applicants must complete this section.)

Applicant name

 

Facility name

 

 

 

 

 

 

 

 

 

Mailing address

 

Physical

 

 

 

 

 

address, if

 

 

 

 

 

different

 

 

 

 

 

 

 

 

 

Business phone

 

County where property is located

 

 

 

 

 

 

 

 

Parcel identification number or legal description

 

 

 

 

 

 

 

 

 

 

 

1. On January 1 of the current year, was the applicant a Florida not-for-profit corporation?

Yes

No

If yes, attach a copy of the filing confirmation letter from the Florida Department of State, a copy of the Articles of Incorporation, as amended, and a copy of the Bylaws, as amended. If qualified as charitable under section 501(c)(3) of the Internal Revenue Code, attach a copy of the determination letter issued by the Internal Revenue Service.

If no, attach a copy of the applicant’s Articles of Organization, as amended, and other organizing documents evidencing the organization’s purpose.

2. How is the property used? (Attach additional pages if needed.)

3. Is any portion of the property rented or leased?

Yes

No

If yes, attach a copy of all rental and lease contracts in effect during the last calendar year.

4.Is any portion of the property used for non-exempt purposes as provided in ss. 196.196 and 196.197, F.S.?

Yes No

If yes, provide a detailed explanation. (Attach additional pages if needed.)

For use by property appraisers

Application Number ______________________

 

 

 

DR-504

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Page 2 of 3

Hospitals, Nursing Homes, and Homes for Special Services

1. On January 1 of the current year, was the applicant qualified as charitable under section 501(c)(3) of the

Internal Revenue Code, as determined by the Internal Revenue Service? Yes No

If yes, attach a copy of the determination letter from the Internal Revenue Service, a copy of the Articles of Incorporation, as amended, and a copy of the Bylaws, as amended.

2.On January 1 of the current year, did the organization hold a valid license issued by the Agency for Health Care Administration under

Chapter 395, F.S. – Hospital or Ambulatory Surgical Center

Yes

No

Chapter 400, F.S. – Nursing Home, Home for Special Services and Related

Health Care Facility, or

Yes

No

Part I, Chapter 429, F.S. – Assisted Living Facility?

Yes

No

If yes, attach a copy of the license issued by the Agency for Health Care Administration.

Attachments (All applicants must attach the following information to this application.) On each attachment, include your name, address, and an indication that the information is an attachment to this application.

1.Provide a copy of the organization’s most recent financial statement.

2.Provide a copy of the organization’s most recent federal tax return (if filed).

3.Provide the following fiscal and other records showing in reasonable detail the financial condition, record of operation, and exempt and nonexempt uses of the property, where appropriate, for the immediately preceding fiscal year:

a.A schedule of payments or advances, directly or indirectly, by way of salaries, fees, loans, gifts, bonuses, gratuities, drawing accounts, commissions or other compensation (except reimbursements for reasonable out-of-pocket expenses incurred on behalf of the applicant) to

any officer, director, trustee, member, or stockholder, or

any person, company, or other entity directly or indirectly controlled by the applicant.

b.An explanation for the guarantee of any loan to or obligation of any officer, director, trustee, member, or stockholder of the applicant or any entity directly or indirectly controlled by the applicant.

c.Any contractual arrangement by the applicant or any officer, director, trustee, member, or stockholder of the applicant regarding the

rendition of services;

provision of goods or supplies;

management of the applicant;

construction or renovation of the property;

procurement of the real, personal, or intangible property; and

other similar financial interest in the affairs of the applicant.

d.A schedule of payments or amounts for

salaries for operation;

services received;

supplies and materials;

reserves for repair, replacement, and depreciation of the property;

any mortgage, lien, and other encumbrances; and

other purposes (explain).

e.A schedule of charges for services rendered by the applicant. If the charges for services rendered exceed the value of the services rendered, information on whether the excess is used to pay maintenance and operational expenses furthering its exempt purpose or to provide services to persons unable to pay for the services.

f.An affirmative statement that no part of the property, or no part of the proceeds of the sale, lease, or other disposition of the property, will inure to the benefit of its members, directors, or officers, or to any person or firm operating for a profit or for a nonexempt purpose.

DR-504

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Page 3 of 3

Signature (ALL applicants must complete this section.)

Florida law requires property appraisers to determine whether an organization uses the identified property for exempt purposes before granting an ad valorem tax exemption. Property appraisers will notify you if additional information or documentation is needed to determine eligibility for the exemption requested.

I certify all information on this application, including any attachments, is true, correct, and in effect on January 1 of the tax year.

Signature

Title

Date

Need Help?

 

In Florida, local governments are responsible for administering property tax. The best

 

 

resource for assistance is the property appraiser in the county where the property is

 

 

located. Find websites for county property appraisers at:

FloridaRevenue.com/Property/Pages/LocalOfficials.aspx

File Specifics

Fact Name Details
Purpose of Form This form is used by nonprofit organizations to apply for an ad valorem tax exemption for property used primarily for exempt purposes.
Governing Laws The form is governed by sections 196.195, 196.196, and 196.197 of the Florida Statutes.
Eligible Organizations Charitable, religious, scientific, literary organizations, hospitals, nursing homes, and homes for special services can apply.
Filing Deadline Applications must be submitted to the county property appraiser by March 1 of the current tax year.
Required Attachments Organizations must attach financial statements, federal tax returns, and documentation of property use and management.
501(c)(3) Status If applicable, organizations must provide a determination letter from the IRS confirming their 501(c)(3) status.
Property Use The application requires details on how the property is used and whether any part is rented or leased.
Licensing Requirements Hospitals and nursing homes must hold valid licenses from the Agency for Health Care Administration as of January 1 of the current year.
Certification All applicants must certify that the information provided is true and correct as of January 1 of the tax year.

How to Use Dr 504 Florida

Completing the DR 504 Florida form requires careful attention to detail and accurate information. This form serves as an application for ad valorem tax exemption for nonprofit organizations. Below are the steps to guide you through the process of filling out the form.

  1. Begin with the General Information section at the top of the form. Fill in the following details:
    • Applicant name
    • Facility name
    • Mailing address
    • Physical address (if different)
    • Business phone
    • County where property is located
    • Parcel identification number or legal description
  2. Answer the question regarding whether the applicant was a Florida not-for-profit corporation on January 1 of the current year. If "Yes," attach the required documents, including:
    • A copy of the filing confirmation letter from the Florida Department of State
    • A copy of the Articles of Incorporation, as amended
    • A copy of the Bylaws, as amended
    • If applicable, a copy of the IRS determination letter for 501(c)(3) status
  3. If the answer is "No," attach the Articles of Organization and any other organizing documents that show the organization’s purpose.
  4. Describe how the property is used. If necessary, attach additional pages for a detailed explanation.
  5. Indicate whether any portion of the property is rented or leased. If "Yes," attach copies of all rental and lease contracts from the last calendar year.
  6. Answer whether any part of the property is used for non-exempt purposes. If "Yes," provide a detailed explanation and attach additional pages if needed.
  7. If applicable, complete the section specific to Hospitals, Nursing Homes, and Homes for Special Services. Answer the questions regarding 501(c)(3) status and licensing by the Agency for Health Care Administration. Attach the required documentation as specified.
  8. Prepare the Attachments section. Include the following documents:
    • A copy of the organization’s most recent financial statement
    • A copy of the organization’s most recent federal tax return (if filed)
    • Detailed fiscal records from the previous fiscal year, including:
      • A schedule of payments to officers, directors, or controlled entities
      • An explanation for any loan guarantees
      • Any contractual arrangements regarding services, goods, or management
      • A schedule of operational payments and expenses
      • A schedule of charges for services rendered
      • An affirmative statement regarding the use of property proceeds
  9. Complete the Signature section. Sign and date the application, certifying that all information is true and correct as of January 1 of the tax year.

After filling out the form, ensure that you have all required attachments. Submit the completed application to the county property appraiser by the deadline of March 1 of the current tax year. If you have questions or need assistance, reach out to the property appraiser in your county.

Your Questions, Answered

What is the purpose of the DR 504 Florida form?

The DR 504 Florida form serves as an application for ad valorem tax exemption specifically for nonprofit organizations. This includes charitable, religious, scientific, literary organizations, as well as hospitals, nursing homes, and homes for special services. By completing this form, organizations can seek exemption for property that is predominantly used for these exempt purposes, as outlined in Florida Statutes sections 196.195, 196.196, and 196.197.

Who is eligible to apply for an exemption using the DR 504 form?

Eligibility for the DR 504 form is primarily determined by the nature of the organization and the use of the property. Organizations must be classified as Florida not-for-profit corporations. They should also demonstrate that their property is used predominantly for exempt purposes. If the organization qualifies under section 501(c)(3) of the Internal Revenue Code, it must provide documentation, including a determination letter from the IRS. Additionally, hospitals and nursing homes must hold valid licenses from the Agency for Health Care Administration.

What documents must be submitted with the DR 504 application?

When submitting the DR 504 application, several key documents are required:

  • A copy of the organization’s most recent financial statement.
  • A copy of the organization’s most recent federal tax return, if applicable.
  • Detailed fiscal records that outline the financial condition and operations of the property for the previous fiscal year.
  • Any relevant contracts or agreements related to the use of the property.
  • An affirmative statement confirming that no part of the property will benefit individuals operating for profit.

Each attachment should clearly indicate the organization’s name and address, as well as that it is part of the application.

When is the deadline for submitting the DR 504 application?

The completed DR 504 application, along with all required attachments, must be filed with the county property appraiser by March 1 of the current tax year. Timely submission is crucial, as late applications may not be considered for the tax exemption. It is advisable for organizations to plan ahead and ensure that all necessary documentation is gathered well before the deadline.

Common mistakes

  1. Incomplete Information: Many applicants forget to fill out all required fields. This can lead to delays or denials. Ensure that every section is completed accurately, including the applicant name, facility name, and contact information.

  2. Missing Attachments: Failing to include necessary documents is a common mistake. Attachments such as the Articles of Incorporation, financial statements, and any required licenses must accompany the application. Double-check that all relevant documents are included.

  3. Incorrect Filing Deadline: Submitting the application after the March 1 deadline can result in disqualification. It is crucial to be aware of this date and ensure that the completed form is filed on time.

  4. Not Providing Detailed Explanations: When answering questions about property use, many applicants provide vague responses. Detailed explanations are necessary, especially if any part of the property is used for non-exempt purposes. Attach additional pages if needed.

  5. Signature Issues: Some applicants neglect to sign the application or provide an incomplete signature. All applicants must sign and date the form to certify that the information is true and correct.

Documents used along the form

The DR-504 Florida form is essential for nonprofit organizations seeking an ad valorem tax exemption. However, several other documents often accompany this application to ensure a complete submission. Below is a list of these supporting forms and documents, each serving a specific purpose in the application process.

  • Articles of Incorporation: This document outlines the organization’s purpose and structure. It is crucial for proving the nonprofit status of the applicant.
  • Bylaws: Bylaws govern the internal management of the organization. They detail how the organization operates and are required to demonstrate compliance with nonprofit regulations.
  • IRS Determination Letter: This letter confirms the organization’s 501(c)(3) status. It is vital for verifying eligibility for tax exemptions.
  • Financial Statements: Recent financial statements provide insight into the organization’s financial health. They help appraisers assess the organization’s operations and use of property.
  • Federal Tax Return: If filed, this document offers additional financial information. It supports the claims made in the financial statements.
  • Rental and Lease Contracts: If any property is rented or leased, these contracts must be included. They clarify how the property is used and whether it aligns with exempt purposes.
  • License from Agency for Health Care Administration: For hospitals and nursing homes, this license is necessary to prove compliance with state regulations.

Submitting the DR-504 form alongside these documents ensures a thorough review by the property appraiser. This increases the likelihood of securing the desired tax exemption. Be prepared and organized to streamline the process.

Similar forms

The DR-501 form is an application for exemption from ad valorem taxes for property owned by charitable organizations. Like the DR-504, it requires the organization to demonstrate that the property is used predominantly for exempt purposes. Both forms ask for detailed information about the organization’s status, including whether it is a nonprofit and if it qualifies under section 501(c)(3) of the Internal Revenue Code. The DR-501 focuses specifically on charitable organizations, while the DR-504 encompasses a broader range of entities, including hospitals and religious organizations.

The DR-420 form is used for the application of homestead exemptions in Florida. Similar to the DR-504, it requires applicants to provide information about their ownership and use of the property. Both forms necessitate proof of eligibility, such as identification and financial statements. However, the DR-420 is aimed at individual homeowners, whereas the DR-504 targets nonprofit organizations seeking tax exemptions for properties used for charitable, religious, or scientific purposes.

The DR-486 form serves as a request for a property tax exemption for educational institutions. This document shares similarities with the DR-504 in that both require proof of the organization’s exempt status and details about how the property is utilized. Each form mandates that applicants submit supporting documentation, including financial records and proof of nonprofit status. The DR-486 is specifically tailored for schools and educational entities, while the DR-504 covers a wider array of nonprofit purposes.

The DR-501C form is used for claiming a tax exemption for property owned by a nonprofit organization that is primarily used for educational purposes. This form parallels the DR-504 in its requirement for detailed financial disclosures and proof of nonprofit status. Both documents focus on ensuring that the properties are used for their stated exempt purposes. However, the DR-501C is specifically designed for educational entities, whereas the DR-504 applies to a broader spectrum of nonprofit organizations, including those in health care and religious sectors.

Dos and Don'ts

When completing the DR-504 Florida form, careful attention to detail is essential. Here are some guidelines to follow and some common pitfalls to avoid:

  • Do ensure that all required attachments are included with your application.
  • Do provide accurate and complete information about your organization and property usage.
  • Do file your application before the March 1 deadline to avoid complications.
  • Do double-check your financial statements and tax returns for accuracy before submission.
  • Don't leave any sections of the application blank; provide explanations where necessary.
  • Don't forget to include your name and address on all attachments.
  • Don't submit outdated documents; ensure all attachments are current and relevant.
  • Don't assume that verbal communication with the property appraiser is sufficient; always provide written documentation.

Misconceptions

Understanding the DR 504 Florida form is crucial for nonprofit organizations seeking tax exemptions. However, several misconceptions can lead to confusion. Here are six common misconceptions:

  • Misconception 1: Only religious organizations can use the DR 504 form.
  • This is incorrect. The form is available for various nonprofit organizations, including charitable, scientific, literary, hospitals, nursing homes, and homes for special services.

  • Misconception 2: The application can be submitted any time during the year.
  • In reality, the completed application must be filed with the county property appraiser on or before March 1 of the current tax year.

  • Misconception 3: If an organization has a 501(c)(3) status, it automatically qualifies for the exemption.
  • While 501(c)(3) status is a requirement, the organization must still demonstrate that the property is used predominantly for exempt purposes.

  • Misconception 4: Only the property owner needs to fill out the form.
  • All applicants, including lessees, must complete the form and provide necessary documentation regarding property use and financial details.

  • Misconception 5: The DR 504 form is a one-time submission.
  • This is misleading. Organizations must submit the form annually to maintain their exemption status, ensuring compliance with current regulations.

  • Misconception 6: Additional documentation is optional.
  • On the contrary, the application requires specific attachments, such as financial statements and tax returns, to substantiate the request for exemption.

Key takeaways

Filling out the DR 504 Florida form is a crucial step for nonprofit organizations seeking an ad valorem tax exemption. Here are key takeaways to ensure a smooth application process:

  • Eligibility Criteria: Only Florida not-for-profit corporations can apply. Confirm your status by providing necessary documentation, such as the Articles of Incorporation and IRS determination letter, if applicable.
  • Deadline Awareness: Submit the completed application, along with all required attachments, by March 1 of the current tax year to avoid penalties.
  • Property Use Documentation: Clearly describe how the property is used. If any part of the property is rented or used for non-exempt purposes, provide detailed explanations and relevant contracts.
  • Required Attachments: Include recent financial statements, federal tax returns, and detailed records of the organization’s operations, including compensation schedules and service charges.
  • Signature Requirement: Ensure that the application is signed and dated. This confirms that all information provided is accurate and true as of January 1 of the tax year.
  • Seek Assistance: For questions or clarifications, contact the county property appraiser. They are the best resource for guidance throughout the application process.