**Table 1: Section 8002-Eligible Federal Property in the Local Educational Agency Applicant Name:**  **Impact Aid Number: School Year:**  **Instructions:** List all Section 8002-eligible Federal property in the LEA. When the eligible federal property is located in more than one jurisdiction, enter the total number of acres in each jurisdiction. In column 1, enter the name of the Section 8002-eligible Federal property. In column 2, enter the name of the corresponding taxing jurisdiction. In column 3, enter the number of acres associated with and approved as eligible federal acres for the purposes of the Impact Aid Program.

**Name of Section 8002-Eligible Federal Property (Generally, real property to which the Federal Government acquired** 

**ownership on or after 1939) Column 1**  **Column 2 Number of Section 8002-**  **eligible Acres Column 3**  **Taxing Jurisdiction**

**If federal Impact Aid Program Section 8002-eligible acres total has changed from last year's submission, provide an explanation and attach/upload official documentation for the change.**  **TOTAL NUMBER OF SECTION 8002-ELIGIBLE FEDERAL ACRES:**

### Table 2: Revenue from Eligible Federal Property

**Applicant Name: Impact Aid Number:**  **School Year: Instructions:**  List all revenue from Federal and non-Federal sources during the second preceding fiscal year (e.g., 2011-2012 for the FY 2014 application) from activities associated with section 8002-eligible Federal property. If revenue is from Federal programs, provide the name of each Federal program and the name of the Federal agency responsible for administering that program. If only a portion of the Federal property generating the revenue is eligible under section 8002, prorate the revenue to reflect the share attributable to the section 8002-elgible property. For example, if the LEA has 10,000 acres of U.S. Forest Service property that generated $20,000 in timber revenues, but only 2,000 acres are eligible under section 8002, the LEA should report one-fifth (20 percent) of the total, or $4,000, as revenue associated with section 8002-eligble Federal property. Do not report Impact Aid revenue or receipts from other U.S. Department of Education programs on this table. 

### Column 2 **Funds Received During Fiscal Year (2011-2012)**

**TOTALS: Column 1**  **Source of Revenue (If Federal, also List Federal Agency and Program)**

### Table 3: Total Acreage and Taxable Value in the Local Educational Agency

**Applicant Name: Impact Aid Number:**  **School Year:**

2. If the documentation was obtained directly from a local official (e.g., local tax assessor for the data on taxable value), you must submit a certification by that official that includes the person's name, title, email address, and telephone number. 

### TOTALS: **Attachment: You must upload documentation showing where the data was obtained. The two options are:** 1. Attach the source of the official data, such as a document from your State's website, or website link. **Instructions:**Enter the total acreage located in the local educational agency (LEA) and the total taxable value for the purpose of levying property tax for school purposes for current expenditures of real property located within the boundaries of the local educational agency (LEA). In column 1, enter the name of the taxing jurisdiction. This information must match the jurisdictions listed on Table 1. In column 2, enter the total acres located in the LEA boundaries or taxing jurisdiction (including the Section 8002-eligible acres and other non-taxable acres). In column 3, enter the total taxable value, for the purposes of levying property tax for school purposes for current expenditures, of the acres listed in column 2, for the prior fiscal year (e.g., use fiscal year 2008-2009 for the FY 2010 application or the specific taxable value as of January 2009). If the LEA is located in more than one taxing jurisdiction (e.g., two counties) or contains more than one taxing jurisdiction (e.g., two townships), enter the information for each jurisdiction separately.



### Column 1 **Column 2 Column 3**  **Name of Taxing Jurisdiction (e.g., township name,**

**city name, county name, etc.) Total Acres located in LEA**  **boundaries (or taxing jurisdiction)**  **Total Taxable Value of Real Property in the LEA**

### Table 4: Tax Levy Information

**Applicant Name: Impact Aid Number:**  **School Year:** Instructions: Enter the local real property tax levy, in mills or dollars, that was used to raise funds for current operating expenditures for the local educational agency (LEA) for the prior fiscal year (e.g., FY 2012-2013 data for the FY 2014 application). Enter a single tax rate for school operations expenditures for all types of real property in the jurisdiction. When funds for current operating expenditures for the LEA are raised by more than one taxing jurisdiction, enter the tax rate information for each additional jurisdiction on a separate line.



### Column 1 **Column 2 Name of taxing jurisdiction (e.g., school district name, township name, city name,**  **county name, etc.) Use separate line for each different taxable jurisdiction in the LEA.**  **Tax Rate for Current Operating Expenditures for This LEA for Fiscal Year 2012-2013 (e.g., 2.5 mills**  **per $1.00 or $2.50 per $1,000)**