Form DR-504 at a glance
What it is: Form DR-504 is the Ad Valorem Tax Exemption Application and Return for Charitable, Religious, Scientific, Literary Organizations, Hospitals, Nursing Homes, and Homes for Special Services.
Who signs: All applicants must complete the Signature section.
This application is for use by nonprofit organizations to apply for an ad valorem tax exemption for property used predominantly for an exempt purpose.
What to bring and attach to Form DR-504
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.
Provide a copy of the organization's most recent financial statement.
Provide a copy of the organization's most recent federal tax return (if filed).
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 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.
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.
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.
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).
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.
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.
A filled-in Form DR-504 example: a charity checks Charitable on page 1
How to fill out Form DR-504, box by box
Select all that apply
Select all that apply: Charitable, Religious, Scientific, Literary, Hospital, Nursing Home, Homes for Special Services.
File with the county property appraiser by March 1
File the completed application, including all required attachments, with the county property appraiser on or before March 1 of the current tax year.
General Information (All applicants must complete this section.)
In General Information, which all applicants must complete, enter the Applicant name and the Facility name.
Enter the Mailing address and the Physical address, if different.
Enter the Business phone, the County where the property is located and the 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
Attach Articles of Incorporation or Articles of Organization, and 2. How is the property used?
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?
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?
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.)
Hospitals, Nursing Homes, and Homes for Special Services
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.
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.
Signature, Title and Date
Sign to certify all information on this application, including any attachments, is true, correct, and in effect on January 1 of the tax year.
Sign on the Signature line, then enter the Title and the Date.
Property appraisers will notify you if additional information or documentation is needed to determine eligibility for the exemption requested.
More rules for Form DR-504
Application Number is for use by property appraisers.
Common questions about Form DR-504
Who signs it?
All applicants must complete the Signature section.
Where to get help with Form DR-504
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
Sources
[1] Form DR-504 (R. 11/21), Ad Valorem Tax Exemption Application and Return for Charitable, Religious, Scientific, Literary Organizations, Hospitals, Nursing Homes, and Homes for Special Services, Florida Department of Revenue (the Official source link on this page).