Fillable Massachusetts Environmental Police - Request Form for Fee Exemption ATV/Snowmobile

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Massachusetts Environmental Police - Request Form for Fee Exemption ATV/Snowmobile

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The Massachusetts Environmental Police - Request Form for Fee Exemption ATV/Snowmobile form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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Commonwealth of Massachusetts
Massachusetts Environmental Police Ph: 617-626-1650
251 Causeway Street, Suite 101, Boston, MA 02114-2153 Fax: 617-626-1670
_________________________________________________________________________________________
REQUEST FORM FOR FEE EXEMPTION ATV/SNOWMOBILE
_________________________________________________________________________________________
In accordance with the Commonwealth of Massachusetts general laws Chapter 90B, Section 22, the business / individual
listed below has applied for a fee exemption for the following recreational vehicle/snowmobile:
Type: 4-Wheel UTV
Trailbike Other (Specify)
(Manufacturer)
Snowmobile
Year: _________ Color: ____________
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(Vehicle Identification Number) (VIN)
Name of Business (if applicable):
Name of Individual:
Physical Address:
Mailing Address:
Phone #: Alternate Phone #:
__________________________________________________________________________________________________________________
Vehicle Used Exclusively For: The undersigned hereby certifies under the pains and penalties of
(Please check one)
perjury that this vehicle is used exclusively for the purpose checked.
Agriculture
Forestry ______________________________________________
Lumbering Applicant’s Signature
Construction
_________________________________________________________________________________________________________________
NOTARY SEAL:
State of ________________________________ County of __________________________________
On this _______________________ day of _________________________. _______________________ before me personally appeared
___________________________________, to me known to be the person described in and who executed the foregoing instrument and
acknowledged that he/she executed the same as his/her free act and deed, for the purposes therein set forth.
______________________________________
(Notary Public Signature)
______________________________________ ___________________________________
(Notary Public Printed Name) My Commission Expires
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Massachusetts Environmental Police - Request Form for Fee Exemption ATVSnowmobile

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Completed 20 May 2020

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