FOR TAX YEAR:__________________
NAME OF SPOUSE APPLYING FOR EXEMPTION:_________________________________
NAME OF ACTIVE-DUTY SERVICE
MEMBER:____________________________________
I, the undersigned, do hereby attest that the answers given in this affidavit are true and
correct and that I am the spouse of _________________________________, an active-duty
military member with
legal residence other than Virginia who is in compliance with military
orders, and I am in Virginia solely to be with my spouse.
Pursuant to the Service-member Civil Relief Act (SCRA) as amended by the Veterans Benefits
and Transitions Act (VBTA), effective January 1, 2019, I elect the same legal residence in the
state of _______________________ as my military spouse pursuant to the SCRA as amended
by the Military Spouses Residency Relief Act (MSRRA) in 2009.
The following required documents are attached to support the personal property tax
exemption as authorized by the SCRA as amended:
• My Military Spouse Identification card
• Service-members current Leave and Earnings Statement (LES) indicating a legal state of
residency other than Virginia for the tax year referenced above.
Furthermore, I affirm that I am the owner/co-owner of the following vehicle(s) and that said
vehicle(s) are not used in a trade or business:
______ __________ _______________ _______________________________
Year Make Model Account # or VIN#
______ __________ _______________ _______________________________
Year Make Model Account # or VIN#
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