1. Property tax exemption/Dakota Ag Co-op

Business Competition 25. Is any similar business being conducted by other operators in the municipality? DYes III No I If YES, give name and location of competing bosiness or businesses Property Tax Liability Disclosure Statement 26. Does the project operator own real property in North Dakota which has delinquent property tax levied against it? 0 Yes III No 27. Does the project operator own a greater than 50% interest in a business that has delinquent property tax levied against any of its North Dakota real property? 0 Yes III No If the answer to 26 or 27 is Yes, list and explain I Use Only When Reapplying 28. The project operator is reapplying for property tax incentives for the following reason(s): o To present additional facts or circumstances which were not presented at the time of the original application o To request continuation of the present property tax incentives because the project has: o moved to a new location o had a change in project operation or additional capital investment of more than twenty percent o had a change in project operators o To request an additional annual exemption for the year of on structures owned by a governmental entity and leased to the project operator. (See N.D.C.C. ~ 40-57.1-04.1) Notice to Competitors of Hearing Prior to the hearing, the applicant must present to the governing body of the county or city a copy of the affidavit of publication giving notice to competitors unless the municipality has otherwise determined there are no competitors. I, Dennis J Novacek , do hereby certify that the answers to the above questions and all of the information contained in this application, including attachments hereto, are true and correct to the best of my knowledge ~d belief and that no relevant fact pertaining to the ownership or operation of the project has been omitted. ___~ ' ."., _ \'r\i~"---- General manager 09/22/2005 ~ignature Title Date In compliance with the Federal Privacy Act of 1974, Public Law 93-579, the disolouse of the individual's social seourity number on this form is mandatory pursuant to North Dakota Century Code ~~ 40-57.1-03 and 40-57.1-07. An individual's social security number is used as an identification number by the Office of State Tax Commissioner for file control purposes and record keeping. Certification of Governing Body (To be completed by the Auditor of the City or County) The municipality shall, after granting any property tax incentives, certify the findings to the State Tax Commissioner and Director of Tax Equalization by submitting a copy of the project operator's application with the attachments. The governing body, on the _ day of ,20-, granted the following: o Property Tax Exemption Number of years Percent of exemption o Payments in lieu of taxes Beginning year Ending year Amount of annual payments (Attach schedule if payments will vary) Auditor