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地價稅自用住宅用地Application for Self-Use Residential Land Value Tax Rate

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※日後如需變更繳款書送單地址,請以網路或書面向本分局辦理更址。
If you need to change the delivery address of payment slips in the future, please contact this branch online or in writing to change the address.
本人所有上列房屋尚有下列人士及其家屬設立戶籍,惟確無租賃關係,如有不實願意補繳稅款,並依法接受處罰。 (有本人、配偶、直系親屬或三親等親屬以外之他人設籍才需填寫)
The following persons and their families have registered their household registrations for all the houses listed above, but there is no rental relationship. If there is any false information, I am willing to pay the tax and accept the punishment according to law. (This needs to be filled in only if there are people other than myself, my spouse, direct relatives or third degree relatives who have registered their household registrations)
原已核准享受自用住宅用地稅率課徵地價稅,願放棄該處改按一般用地稅率課徵地價稅,請填寫該處地段地號(若放棄之土地非本人所有,請另外檢附地價稅依土地稅法第17條第3項規定適用自用住宅用地申明書)
If you have been approved to enjoy the land tax rate for self-use residential land, and you wish to give up the land tax and pay the land tax at the general land tax rate, please fill in the lot number of the land (If the land you are giving up is not yours, please also attach a declaration that the land tax is applicable to self-use residential land in accordance with Article 17, Paragraph 3 of the Land Tax Act)
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