Fillable Commonwealth of Massachusetts Form 99 Application for Property Tax Deferral

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Commonwealth of Massachusetts Form 99 Application for Property Tax Deferral

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The Commonwealth of Massachusetts Form 99 Application for Property Tax Deferral form is 4 pages long and contains:

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State Tax Form 99
The Commonwealth of Massachusetts
Assessors’ Use only
Issued 11/2016
Date Received
Application No.
Name of City or Town
Parcel Id.
FINANCIAL HARDSHIP
FISCAL YEAR _______ APPLICATION FOR PROPERTY TAX DEFERRAL
General Laws Chapter 59, § 5, CLAUSE 18A
THIS APPLICATION IS NOT OPEN TO PUBLIC INSPECTION
(See General Laws Chapter 59, § 60)
Return to: Board of Assessors
Must be filed with assessors on or before April 1, or 3
months after actual (not preliminary) tax bills are mailed for
fiscal year if later. Tax Deferral and Recovery Agreement
(Form 99-1) must accompany application unless already on file
and persons with interest in property remain the same.
INSTRUCTIONS: Complete all sections that apply. Please print or type.
A. IDENTIFICATION. Complete this section fully.
Name of Applicant _________________________________________ Occupation
__________________________________
Telephone Number _________________________
Marital Status ________________________________
Legal Residence (Domicile) on July 1, _________
No. Street City/Town Zip Code
Location of Property:
Mailing Address
(If different)
No. of Dwelling Units: 1 2 3 4 Other
Did you occupy the property on July 1, __________ and for the prior 10 years? Yes No
If no, list the other properties you occupied during the past 10 years.
Address Dates
Continue list on attachment in same format as necessary.
Have you been granted any exemption in any other city or town (MA or other) for this year? Yes No
If yes, name of city or town Amount exempted $
DISPOSITION OF APPLICATION (ASSESSORS’ USE ONLY)
Ownership GRANTED Assessed tax $
Occupancy DENIED Deferred tax $
Status DEEMED DENIED Adjusted tax $
Financial condition Board of Assessors
Date voted/Deemed denied
Certificate No.
Date Cert./Notice sent
Date:
FILING THIS FORM DOES NOT STAY THE COLLECTION OF YOUR TAXES
THIS FORM APPROVED BY THE COMMISSIONER OF REVENUE
B. PERSONS WITH INTEREST IN PROPERTY.
Did you own the property on July 1, ___________ as
Sole owner Co-owner with spouse only
Co-owner with others?
Was there a mortgage on the property as of July 1, __________? Yes No
If yes, name of mortgagee(s)
Was the property subject to a life estate as of July 1, _________? Yes No
If yes, name(s) of Remaindermen (person(s)receiving property after your death)
Was the property subject to a trust as of July 1, ________ ? Yes No
If yes, please attach trust instrument including all schedules.
C. REASON FOR HARDSHIP. Check the reason that applies and provide requested information.
ACTIVATED MILITARY PERSONNEL
Initially enlisted in the armed forces.
Military status changed to active duty.
Date of activation to active duty. _______________________________ Attach copy of orders.
UNEMPLOYMENT
Provide employment history over the last two years, including employer(s), dates, salaries, reasons for leaving.
ILLNESS OR DISABILITY
Provide a detailed description of the physical or mental illness, disability or impairment.
Attach a physician’s letter documenting the illness or disability.
OTHER
Provide a detailed explanation.
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
D. FAMILY ASSISTANCE. Complete this section if you are receiving any financial assistance from family members.
Name Relationship Residence Occupation Wages Assistance given
____________________ __________________ __________________ ________________ _____________ ______________
____________________ __________________ __________________ ________________ _____________ ______________
Continue list on attachment in same format as necessary.
E. FINANCIAL STATEMENT. Complete this section fully. Copies of your federal and state tax returns and other
documentation may be requested to verify your income and assets.
ASSETS LIABILITIES
REAL ESTATE
Domicile value $ Mortgage outstanding balance $
Other value
PERSONAL ESTATE
Motor vehicle values (year/make/model)
Car loan balances
Bank account balances (Bank name & address)
Other (specify) Other outstanding debts (personal loans, credit
cards, etc.)
TOTAL $ TOTAL $
INCOME
Monthly
EXPENSES
Monthly
Wages & salaries -Annual $ $ Mortgage payments (including taxes) ........$
Unemployment compensation................... Food...................................................................
Social Security .............................................. Utilities:
Other pension/retirement .......................... Electricity .....................................................
Public assistance: Gas ................................................................
AFDC........................................................ Heating fuel.................................................
Food stamps............................................. Telephone ....................................................
Fuel assistance ......................................... Water/sewer ...............................................
Other ......................................................... Debt payments:
Rental income ............................................... Car loans ......................................................
Business/professional profits .................... Credit cards .................................................
Interest/dividends....................................... Personal loans .............................................
Other (specify) Fixed expenses:
Car insurance ..............................................
House insurance .........................................
Other (specify)
TOTAL $ TOTAL $
F. SIGNATURE. Sign here to complete the application.
This application has been prepared or examined by me. Under the pains and penalties of perjury, I declare that to the
best of my knowledge and belief, this return and all accompanying documents and statements are true, correct and
complete.
Signature Date
If signed by agent, attach copy of written authorization to sign on behalf of taxpayer.
TAXPAYER INFORMATION ABOUT FINANCIAL HARDSHIP PROPERTY TAX DEFERRAL
FINANCIAL HARDSHIP DEFERRAL. You may be able to defer all or a portion of the taxes assessed on your domicile if
you do not have the financial resources to pay them because of a change to active military service (not including initial
enlistment), unemployment, illness or other type of temporary hardship. Qualifications are established locally by the
board of assessors. More detailed information may be obtained from your assessors.
WHO MAY FILE AN APPLICATION. You may file an application if you owned and occupied the property as of July 1,
lived in Massachusetts for at least the previous 10 years and meet all qualifications for a financial hardship deferral.
REPAYMENT. Unlike an exemption, a tax deferral simply allows you to postpone payment of your taxes. If you qualify,
you must enter into a tax deferral agreement that may cover a maximum period of three consecutive fiscal years. At the
end of the deferral, the deferred taxes must be paid, along with interest. You may pay the deferred taxes in five annual
installments, with each installment equal to one-fifth the total deferred taxes, plus interest on the unpaid balance. The
first installment is due two years after the last year of the deferral.
Once you have entered into a tax deferral agreement, the assessors will record a statement at the Registry of Deeds. That
statement continues the lien that already exists on your property by law to ensure the payment and collection of your
taxes. Once the deferred taxes are repaid, the lien is released. However, if the deferred taxes are not paid, your city or
town will be able to recover the amount by foreclosing on the lien in Land Court.
INTEREST. You may also apply for a hardship deferral in either or both of the next two years. If you qualify, you may
defer taxes so long as the amount due, including accrued interest, does not exceed 50% of your share of the full and fair
cash value of the property. Interest at an annual rate of 8% per annum is charged on deferred taxes until the property is
sold, your death, or the death of your surviving spouse if a new agreement has been entered into. The interest rate then
increases to 16% per annum until the deferred taxes are paid.
WHEN AND WHERE APPLICATION MUST BE FILED. Your application must be filed with the assessors on or before
April 1, or 3 months after the actual bills were mailed for t
he fiscal year, whichever is later. THIS DEADLINE
CANNOT BE EXTENDED OR WAIVED BY THE ASSESSORS FOR ANY REASON. IF YOUR APPLICATION IS NOT
TIMELY
FILED, YOU LOSE ALL RIGHTS TO A DEFERRAL AND THE ASSESSORS CANNOT BY LAW GRANT YOU
ONE. AN APPLICATION IS FILED WHEN RECEIVED BY THE ASSESSORS.
PAYMENT OF TAX. Filing an application does not stay the collection of your taxes. Failure to pay the tax when due
may also subject you to interest charges and collection action. To avoid any additional charges, you should pay the tax as
assessed if possible. If a deferral is granted and you have already paid the entire year’s tax as deferred, you will receive a
refund of any overpayment. If you are unable to make your payments, inform the assessors when you file your
application.
ASSESSORS DISPOSITION. Upon applying for a financial hardship deferral, you may be required to provide the
assessors with further information and supporting documentation to establish your eligibility. The assessors have 3
months from the date your application is filed to act on it unless you agree in writing before that period expires to extend
it for a specific time. If the assessors do not act on your application within the original or extended period, it is deemed
denied. You will be notified in writing whether a deferral has been granted or denied.
APPEAL. In order to obtain a review of the assessors’ decision on your application for a financial hardship deferral, you
must bring a civil action in the Superior Court or Supreme Judicial Court. This action must be brought within 60 days of
the decision.
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Commonwealth of Massachusetts Form 99 Application for Property Tax Deferral

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Completed 14 May 2020

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