MOTOR VEHICLE EXCISE ABATEMENT APPLICATION
General Laws Chapter 60A
RETURN APPLICATION FORM AND DOCUMENTATION TO: Board of Assessors Town of Belmont, 19 Moore Street, PO Box 56, Belmont, MA 02478
BILL INFORMATION:
Tax Year Tax Date / Issue Date / / Bill Number
Plate/Registration Number VIN Vehicle Year Make & Model
Name (as shown on bill)
Address (as shown on bill)
City/town State Zip
Mailing Address (if different)
City/town State Zip
REASON YOU ARE APPLYNG FOR AN ABATEMENT:
Check where applicable
You must provide this documentation
Vehicle sold or traded or donated
Bill of sale or donation receipt and
plate return receipt from Registry of Motor
Vehicles (RMV) or new registration form if plate transferred to another vehicle.
Vehicle stolen or total loss
Police report or insurance settlement letter and
plate return receipt, C-19 Form
(Affidavit of Lost or Stolen Plate from RMV) or new registration form.
Vehicle repossessed
Note from lienholder and
plate return receipt, C-19 Form or new registration form.
Vehicle junked
Receipt from junk yard and
plate return receipt, C-19 Form or new registration form.
Vehicle returned (Lemon Law)
Letter from dealer certifying return and
plate return receipt or new registration form.
Moved from
before
Date of move:
/
/
Januar
1 of tax
ea
Proof of residency before January 1 of tax year of bill (e.g., utility bill, voter
registration, lease) and
proof RMV was notified before January 1 of address change
for registration. NOTE: You must notify the RMV within 30 days of moving and before
January 1 to be billed by your new city or town next year.
Moved out of state
Date of move:
Registration from new state or country.
Exemption
Type:
Documentation establishing qualifications.
Other
Explain:
Relevant documentation.
Subscribed under the penalties of perjury.
INSTRUCTIONS. To apply for an abatement (or refund if
excise has been paid), complete this form and provide the
specified documentation.
Abatement applications must be received by the assessors
within three years after the excise was due, or one year after
the excise was paid, whichever is later. To preserve your
right to appeal, you must file on time. By law, assessors may
only act on late applications in limited circumstances where
the excise is still unpaid and their decision in those cases is
final.
Filing an application does not stay the collection of your
excise bill. To avoid interest, charges and collection action,
including non-renewal of your registration, you must pay the
bill in full within 30 days of its issue date. You will receive a
refund if an abatement is granted.
NOTE. You are not entitled to an abatement if you (1)
cancel your registration and retain ownership of the vehicle,
or (2) move to another Massachusetts city or town, during
the calendar year. No excise may be reduced to less than
$5.00. No abatement or refund of less than $5.00 may be
made.
Return this completed form to:
Board of Assessors
Town of Belmont
19 Moore Street, PO Box 56
Belmont , MA 02478
Board of Assessors at 617-993-2630
---------------------Do not write below this line-------------------------
Year __________________ Bill # ______________
Valuation_______________ Months Assessed ________
Excise Assessed $ _____________________
Abatement Allowed $ _____________________
Adjusted Excise $ _____________________
Cert. #_________________ Date:____/______/_________
Assessor_________________________________________
Assessor_________________________________________
Signature:
Date:
Form Approved by Commissioner of Revenue
(STF 126-MVE) (12/2004)
Telephone:
MOTOR VEHICLE EXCISE ABATEMENT APPLICATION
