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Local Economic Revitalization Tax Assistance Act (LERTA) Application

2. The Undersigned hereby makes application to the Norwin School District for exemption from real property taxation under the District’s Local Economic Revitalization Tax Assistance Act (LERTA) Resolution No. 01-2016 to 2017 and submits the following information in support thereof:
4. Name of Applicant:
6. Address
8. City
9. State
10. Zip Code
12. Location of Real Property
14. City
15. State
16. Zip Code
18. Name(s) and Address of Property Owner
20. Source of Title to Real Property (Attach Deed / Sales Agreement)
22. Nature of Improvement(s) and/or New Construction
24. Date Building Permit Issued
    Date Building Permit Issued
25. Attach a Copy of the Building Permit Issued
27. If No Building Permit Required, Date Construction Commenced
    If No Building Permit Required, Date Construction Commenced
29. Date Application Submitted to Board
    Date Application Submitted to Board
    The Undersigned hereby certifies that a copy of this Application was forwarded the Westmoreland County Board of Assessment and Revisions of Taxes on
31. Signature*

    I certify under penalty of perjury that this is a true and accurate statement.

    1. I Agree
32. Today's Date
    Today's Date
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field