City of Brockton
Office of the Collector
45 School Street
Brockton, Massachusetts 02301
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DearSir:
Pleasefurnishme,inaccordancewithSection23B,Chapter60,GeneralLaws,astatementofalltaxes
andassessmentswhichatthistimeconstituteliensonthefollowingproperty.
Propertyassessedto________________ __________________________________________________
KnownasPlotNo.____________________________________________________________________
StreetNo.,ifany_____________________________________________________________________
CondoUnitNo.,if
any_____________________________ ____________________________________
OnParcelNo._____________________whichisonfileattheOfficeoftheAssessorsoftheCityof
Brockton.AlsoattainableontheCity’swebsiteviatheAssessor’sDatabase.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
PLEASENOTE:ALIENCERTIFICATETAKES10WORKINGDAYS.
Requestedby:(pleaseprin t)
Name:_____________ _________________________________________________________________
Street:______________________________________________________________________________
City/Town:_______________________________ ___________________________________________
Telephone:__________________________________________________________________________
BeaccurateonthenumberofplotandMap/Route/Suffix,whichcanbeobtainedattheOfficeofthe
Assessor’sinCityHall,BrocktonoronlineontheCity’swebsiteviatheAssessor’sDatabase.Noother
descriptionwillsufficientlyidentifytheproperty.
THEAPPROPRIATELEGALFEEFROM
THESCHEDULEONTHEBACKOFTHISFORMMUSTBEPAIDAND
FORWARDEDWITHTHISAPPLICATION.
PLEASEENCLOSEALEGALSIZEDSELF‐ADDRESSEDSTAMPEDENVELOPE.