Tax Assessors Office
25 Dorrance Street, RM 208
Providence, RI 02903
Tel: 401-421-5900
Plat: ________ Lot: ________ Unit: ______
APPLICATION FOR
SOCIAL SECURITY EXEMPTION (AGE 62-64)
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 social security exemption
(age 62-64).
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: ___________________________________ E-Mail Address: ___________________________
Address: _______________________________________________________
Providence, Rhode Island ______________
Zip Code
Section Two:
Number of Living Units in Your Residence: _______
Section Three
:
Required Documents: [ ] SS Award Letter [ ] Driver’s License OR [ ] RI ID
THE UNDERSIGNED DOES HEREBY SWEAR THAT THE ABOVE INFORMATION IS TRUE
AND CORRECT TO THE BEST OF HIS OR HER KNOWLEDGE.
___________________________________ ______________________________
APPLICANT SIGNATURE DATE
click to sign
signature
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