TV District Exemption Form

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Per WA State statute 36.95.090, the Methow Valley Communications District of Okanogan County finances its operations by an Excise Tax imposed on properties within the District with televisions. Exemptions to this tax can be claimed by providing this form to the District. By Washington statute, the following are REASONS FOR EXEMPTIONS. PLEASE CHECK THE REASON THAT APPLIES TO YOUR PROPERTY:

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Reason: *

I do not have a television set on the property (a monitor used only for internet streaming is not a television for this purpose)

The owner or tenant is currently subscribed to and receiving services of a community antenna system (CATV) or cable service

The owner or tenant is currently subscribing to and receiving the services of a satellite carrier

After testing, the owner or tenant’s television does not receive at least a class grade B contour signal from the television district’s transmission

Property Owner Name (First Last) *

Parcel Number *

Property Street Address *

City *

State *

Zip Code *

Email Address *

Comment or explanation (optional)

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