Tax Assessors Office
25 Dorrance Street, RM 208
Providence, RI 02903
Tel: 401-421-5900
Plat: ________ Lot: ________ Unit: ______
APPLICATION FOR
ELDERLY EXEMPTION
Applicants must file by March 15
th
. Forms are available at the Providence City Assessors Office. Applicant must
own and reside at the property prior to December 31
st
. A “Residence” is to be considered four (4) living units or
less. Dwellings containing commercial, retail and/or office space are NOT eligible for the elderly exemption.
All exemptions will terminate upon conveyance of the property, death of the person exempted or moving of said
person from the property.
Section One
:
Applicant: ________________________________ Date of Birth: _____________________________
Spouse: ___________________________________ Date of Birth: _____________________________
Phone Number: ___________________________________
Address: _______________________________________________________
Providence, Rhode Island ______________
Zip Code
Section Two
:
1. Do you reside in the property twelve (12) months of the year? Yes / No
2. Number of units in the property? ___________
Section Three
:
Document Submitted as Proof of Age: (Please Check One)
[ ] Driver’s License [ ] Birth Certificate [ ] RI ID [ ] Passport
THE UNDERSIGNED DOES HEREBY SWEAR THAT THE ABOVE INFORMATION IS TRUE
AND CORRECTED TO THE BEST OF HIS OR HER KNOWLEDGE.
___________________________________ ______________________________
APPLICANT SIGNATURE DATE
click to sign
signature
click to edit
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