Fillable Senior-tax-relief-act-application-information Senior Tax Relief Act 2019 Carver

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Senior-tax-relief-act-application-information Senior Tax Relief Act 2019 Carver

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Senior Tax Relief Act 2019
Assessors’ Use only
Carver Tax Form
Revised 8/2019
Date Received
Application No.
Name of City or Town
Parcel Id.
CARVER SENIOR TAX RELIEF ACT 2019 FISCAL
YEAR _______ APPLICATION FORM
Chapter 299 of the Acts of 2018
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
December 1, _______. Any exemption will be
credited on the 3rd and 4th quarter bills.
INSTRUCTIONS: Complete all sections that apply. Please print or type.
A. IDENTIFICATION. Complete this section fully.
Did you own the property on July 1, ______ ? Yes No Single Family Dwelling?: Yes No
If yes, were you: Sole Owner Co-owner Life Estate
Was the property subject to a trust as of January 1? Yes No
If yes, please attach trust instrument including all schedules.
DISPOSITION OF APPLICATION (ASSESSORS’ USE ONLY)
GRANTED
Assessed Tax $
DENIED
Exempted Tax $
DEEMED DENIED
Adjusted Tax $
Board of Assessors
Ownership
Occupancy
Status
Income
Date Voted/Deemed Denied
Certificate No.
Date Cert./Notice Sent
Exemption: Senior Relief
Date:
FILING THIS FORM DOES NOT STAY THE COLLECTION OF YOUR TAXES
THIS FORM APPROVED BY THE BOARD OF ASSESSORS
Name of Applicant: ________________________________________________________________________________________
Home Phone: _______________________ Cell Phone: _______________________ Preference: Home Cell
Email Address:
__________________________________________
Property Address: ________________________________
Mailing Address (If differ
ent)
: _____________________________
City: ________________ State: ______ Zip: _________
City: ___________________ State: _____ Zip: ___________
No
Have you been a resident of the Town of Carver for the previous 10 years? Yes
If yes, were you a resident for longer than 6 months in each of those years? Yes
No
The Commonwealth of Massachusetts
Carver
2020
2019
2019
B. EXEMPTION STATUS. Check each status that applies to you and complete the questions that follow.
Other _______________________
(Please attach DD214.)
SENIOR 65
OR OLDER as of July 1st of the fiscal year for which the exemption is being requested.
Age: _____
Date of Birth: ____________ Joint applicant: Age: ______ Date of birth: ____________
Please attach copy of qualifying birth certificate.
VETERAN 62 OR OLDER as of July 1st of the fiscal year for which the exemption is being requested.
Age: _____
Date of Birth: ____________
Joint applicant: Age: ______ Date of birth: ____________
Type of Discharge: Honorable? Yes
C. GROSS RECEIPTS FROM ALL SOURCES IN PRECEDING CALENDAR YEAR.
Copies of your federal and state tax income returns, and/or other documentation, required to verify your income.
Applicant &
Spouse
Co-owner(s) &
Spouse(s)
Retirement Benefits (Social Security, Railroad, Federal, MA & Political Subdivisions)..
Other Pensions and Retirement Allowances .............
.....................................................…...
Wages, Salaries and other Compensation ......................................................................…...
Net Profits from Business, Profession or Property Rental ..............................................…
Interest and Dividends ......................................................................................................…...
Other Receipts (Capital Gains, Public Assistance, etc.) ................................................…...
TOTALS
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.
Date
If signed by agent, attach copy of written authorization to sign on behalf of taxpayer.
Please attach copy of qualifying birth certificate.
Signature
E. SIGNATURE. Sign here to complete the application.
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Completed 11 July 2020

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