COUNTY OF MONTGOMERY, VIRGINIA
SURVIVING SPOUSE BENEFIT
KILLED IN ACTION
Office of the Commissioner of the Revenue
755 Roanoke St, Suite 1A Christiansburg, VA 24073
Tel: (540) 382-5710 Fax: (540) 381-6838
Email: royalhp@montgomerycountyva.gov
Pursuant to Article X, Section 6-A, subdivision (b) of the Constitution of Virginia, the General Assembly exempted from real
estate taxation, the property which is the primary residence of the surviving spouse of a member of the Armed Forces who
was killed in action. The exemption is equal to the amount of tax due on the dwelling and up to one (1) acre of land. The
exemption may be a pro-rated exemption if the spouse is a partial owner.
The exemption will be given on the dwelling value up to the average assessed value of single family homes in the locality as of
December 31
st
of the previous tax year and the dwelling must be the principal place of residence.
Applications are accepted on a rolling basis. No revalidation is required. The surviving spouse must re-certify with a new
application if the primary residence changes. The spouse must notify the Commissioner of the Revenue of any remarriage.
To apply, complete the application and attach the required proof: a copy of the certification from the Department of Defense
and proof of marriage. Applications are accepted in person or by mail.
Please contact the Office of the Commissioner of the Revenue if you have any questions or if you need assistance with this
application. The office telephone number is 540-382-5710. Office hours are 9:00 am 5:00 pm, Monday through Friday.
APPLICANT INFORMATION
NAME OF SURVIVING SPOUSE
OWNER NAME(S) ON DEED OR TAX BILL
MAILING ADDRESS
PROPERTY ADDRESS (IF DIFFERENT FROM MAILING ADDRESS):
REAL ESTATE ACCOUNT NUMBER
CERTIFICATION STATEMENT
I declare, under penalties provided by law, that this certification has been examined by me and is true, correct and complete to
the best of my knowledge and belief.
Applicant’s Email Address: ______________________________________________________________
_________________________________________ ____________ _________________________
Signature of Applicant Date Signed Telephone Number
_________________________________________ ____________ _________________________
Signature of Witness Date Signed Telephone Number
The application will be returned if the applicant has not signed and/or the signature has not been witnessed by another
adult. If a person is signing with a Power of Attorney, please indicate this on the signature line and include a copy
of the Power of Attorney with the application.
Helen P. Royal, MCR
Master Commissioner
2020
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AUTHORIZATION FOR RELEASE OF INFORMATION
Virginia State Code §58.1-3 does not allow the release of confidential information “except in accordance with a proper
judicial order or as otherwise provided by law”. Without your explicit approval, this office will not release any information
regarding the application to anyone other than the applicant.
If you wish to authorize the Commissioner of the Revenue or his staff to discuss the information contained in your
application with any person(s) other than you (the applicant) and authorize such person(s) to receive information
regarding your eligibility for this program, please complete the section below. You have the right to revoke this
authorization at any time by submitting a written request to our office.
I, or my authorized representative, request that the person specifically named below, as well as agents
representing me, including, but not limited to, Real Estate Agents, a Closing Attorney, or a Mortgage Company
Representative, be allowed to receive or discuss confidential information pertaining to this application.
Name of Contact Person
Address of Contact Person
Telephone of Contact Person
Email of Contact Person
Applicant Signature Authorizing this Release Date
OFFICE USE ONLY BELOW THIS LINE
Certification Checklist
US Department of Defense verification
Proof of marriage
Property occupied as the principal residence of the spouse.
Is the dwelling below qualification threshold? YES NO
Threshold Dwelling Value: $____________ Assessed Value of Application Dwelling $________________
Does the application qualify for tax relief? YES NO If no, list reason:
If qualified, is proration required? YES NO
Is the acreage greater than 1 acre? YES NO Amount of acreage in qualifying parcel acres
List taxable property information below:
Home value exceeding the average single family home value
Land Value over 1 acre
Outbuilding Value
Total Taxable Value
Approved for Exemption:
Signature Date
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