Form 54-015A Application for Broadband Infrastructure Property Tax Exemption - Iowa

Form 54-015A is a Iowa Department of Revenue form also known as the "Application For Broadband Infrastructure Property Tax Exemption". The latest edition of the form was released in January 26, 2018 and is available for digital filing.

Download a PDF version of the Form 54-015A down below or find it on Iowa Department of Revenue Forms website.

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Application for Broadband Infrastructure
Property Tax Exemption
Iowa Code Chapter 427
This application must be filed with the Iowa Department of Revenue by February 1 of the year in which the Broadband
Infrastructure is first assessed for taxation or the following two assessment years.
Applicant Contact Information – Please Print
Name:____________________________________________________________________
Phone: (_____)_____________________ eMail: __________________________________
1. Company Name:___________________________________________________________________________
2. Official Address: ___________________________________________________________________________
3. Address if not the same as Above: _____________________________________________________________
4. Applicable Counties: ________________________________________________________________________
5. Check if locally or centrally assessed. Cable property belonging to companies reporting telephony separately is
locally assessed. Locally assessed under Iowa Code chapter 441
or
Centrally assessed under Iowa Code chapter 433
6. Date of commencement of installation of Broadband Infrastructure:_____________________________
7. Date of completion of installation of Broadband Infrastructure:_________________________________
8. Date of completion is estimated?
Yes
No
9. The following documentation must be attached. Check each item attached.
a. The nature of the Broadband Infrastructure installation, including the number of new line miles
installed within the jurisdiction where seeking to exemption; a description of the property and how it
is related to delivering broadband services; and the taxing districts affected.
b. The percentage of homes, farms, schools, and businesses in the Targeted Service Area (TSA).
That will be provided access to broadband service.
c. The actual cost of installing the Broadband Infrastructure under the project and supporting
documents demonstrating the actual cost. If construction has already begun, include the actual cost
already incurred and the remaining actual cost and supporting documentation.
d. Certification from the Office of the Chief Information Officer (OCIO) pursuant to section 8B.10 that
the installation is being performed or was completed in a TSA.
e. Certification from OCIO that the Broadband Infrastructure installed in the TSA facilities broadband
service at or above 25 megabits per second of download speed and 3 megabits per second of
upload speed.
f.
If applicable, a copy of any nonwireless broadband-related permits issued by a political subdivision.
g. List of taxing districts where Broadband Infrastructure eligible for the exemption has been installed.
INCOMPLETE APPLICATIONS WILL NOT BE APPROVED
Department Authorized Representative
Allowed ____
Disallowed ____
Signed: ____________________________________________________Date:_____________________
Board of Supervisors
Allowed ____
Disallowed ____
Signed: ____________________________________________________Date:_____________________
54-015a(01/26/18)
Application for Broadband Infrastructure
Property Tax Exemption
Iowa Code Chapter 427
This application must be filed with the Iowa Department of Revenue by February 1 of the year in which the Broadband
Infrastructure is first assessed for taxation or the following two assessment years.
Applicant Contact Information – Please Print
Name:____________________________________________________________________
Phone: (_____)_____________________ eMail: __________________________________
1. Company Name:___________________________________________________________________________
2. Official Address: ___________________________________________________________________________
3. Address if not the same as Above: _____________________________________________________________
4. Applicable Counties: ________________________________________________________________________
5. Check if locally or centrally assessed. Cable property belonging to companies reporting telephony separately is
locally assessed. Locally assessed under Iowa Code chapter 441
or
Centrally assessed under Iowa Code chapter 433
6. Date of commencement of installation of Broadband Infrastructure:_____________________________
7. Date of completion of installation of Broadband Infrastructure:_________________________________
8. Date of completion is estimated?
Yes
No
9. The following documentation must be attached. Check each item attached.
a. The nature of the Broadband Infrastructure installation, including the number of new line miles
installed within the jurisdiction where seeking to exemption; a description of the property and how it
is related to delivering broadband services; and the taxing districts affected.
b. The percentage of homes, farms, schools, and businesses in the Targeted Service Area (TSA).
That will be provided access to broadband service.
c. The actual cost of installing the Broadband Infrastructure under the project and supporting
documents demonstrating the actual cost. If construction has already begun, include the actual cost
already incurred and the remaining actual cost and supporting documentation.
d. Certification from the Office of the Chief Information Officer (OCIO) pursuant to section 8B.10 that
the installation is being performed or was completed in a TSA.
e. Certification from OCIO that the Broadband Infrastructure installed in the TSA facilities broadband
service at or above 25 megabits per second of download speed and 3 megabits per second of
upload speed.
f.
If applicable, a copy of any nonwireless broadband-related permits issued by a political subdivision.
g. List of taxing districts where Broadband Infrastructure eligible for the exemption has been installed.
INCOMPLETE APPLICATIONS WILL NOT BE APPROVED
Department Authorized Representative
Allowed ____
Disallowed ____
Signed: ____________________________________________________Date:_____________________
Board of Supervisors
Allowed ____
Disallowed ____
Signed: ____________________________________________________Date:_____________________
54-015a(01/26/18)
Application for Broadband Infrastructure
Property Tax Exemption
Iowa Code Chapter 427
Instructions for the Application for Broadband Infrastructure Property Tax Exemption
Line 1: Enter the name of the company.
Line 2: Enter the address of the property seeking the exemption.
Line 3: Enter the mailing address of the company entered in line 1.
Line 4: List each and every county and/or assessing jurisdiction in which the property seeking an exemption is
located. Attach a separate page, if necessary.
Line 5: Check either the box for locally assessed property under Iowa Code chapter 441 or centrally assessed
property under Iowa Code chapter 433. Cable property is locally assessed if it belongs to a cable company that
reports any of their telephony separately to the Department.
Line 6:
Enter the date qualifying construction work in progress began as reported on the TR1-3 report first
beginning after July 1, 2015 and before July 1, 2020 for installation of Broadband Infrastructure within a Targeted
Service Area.
Line 7: Enter the date or estimated date that qualifying construction is to be completed for a Targeted Service
Area that receives broadband service delivered at or above twenty-five megabits per second of download speed
and three megabits per second of upload speed.
Line 8: Check “Yes” if the date on line 7 has not yet occurred at time of application. Check “No” if the date on
line 7 has already occurred at the time of application.
Line 9: Attach the following items to the application on a separate report:
9a: Complete the Supplemental Section 2A for Qualifying Broadband Infrastructure Pages 1-4 from the
TR1-3 report as shown in the attachment to this application. Also include the number of new line miles
installed within each county and taxing jurisdiction where the exemption is sought.
9b: The percentage of homes, farms, schools, and businesses in the targeted
service area that will be
provided access to broadband service.
9c: The actual cost of installing the Broadband Infrastructure under the project and supporting documents
demonstrating the actual cost. Examples of supporting documents demonstrating the actual cost include
accounting records, construction contracts, invoices, bills of sale, depreciation schedules, or other records.
If construction has begun at the time of application for exemption, provide supporting documentation for the
actual cost incurred beginning after July 1, 2015 and the remaining actual costs yet to be incurred if the
remaining costs are available.
9d: Certification from the Office of the Chief Information Officer (OCIO) pursuant to Iowa Code section 8B.10
that the installation is being performed or was completed in a Targeted Service Area.
9e:
Certification from OCIO that the Broadband Infrastructure installed in the Targeted Service Area
facilitates broadband service at or above twenty-five megabits per second of download speed and three
megabits per second of upload speed.
9f: If applicable, a copy of any nonwireless broadband-related permit issued by a political subdivision.
9g: A list of the taxing districts in which the installation of Broadband Infrastructure subject to the exemption
has occurred or will occur. This list should be in the same format as the supplemental list required to be
provided with the TR1-3 for telephony.
54-015b(11/02/16)

Download Form 54-015A Application for Broadband Infrastructure Property Tax Exemption - Iowa

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