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THE COMMISSIONERS OF LEONARDTOWN

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THE COMMISSIONERS OF LEONARDTOWN
SENIOR CITIZENS EXEMPTION
(Chapter 137, Article I, Sections 1-5)
FY 2021 APPLICATION
HOMEOWNER NAME(S) BIRTHDATE
BIRTHDATE
MAILING ADDRESS
STREET ADDRESS OF DWELLING
Is this your principal residence? Yes No
Total number of residents in household (including applicant)
Please name and provide gross income for each
Name Gross annual income(exclude Social Security)
PLEASE PROVIDE CALENDAR YEAR 2019 TAX RETURNS FOR EACH OF THE ABOVE NAMED PERSONS.
Signed: Date:
Signed: Date:
I HEREBY CERTIFY that on this day of 2020 before me, the subscriber, a Notary Public of the
State of Maryland, in and for County aforesaid, personally appeared
and made oath in due form of law that the aforegoing facts stated in this application
are true and correct.
Notary Public
FOR TOWN USE ONLY
Combined gross income
Reduction of assessment Tax credit
Approved: Date
DEFINITIONS
DWELLING - The dwelling house of one(1) or more homeowners and the lot or curtilage
where the same is erected which is used as the principal residence of such homeowner or
homeowners. No "dwelling" shall be deemed a principal residence which is not actually
occupied or expected to be actually occupied by such homeowner or homeowners for more
than six(6) months of some twelve-month period, including the date of application for
credit. A homeowner or homeowners may claim credit on only one(1) such dwelling. A
homeowner otherwise eligible for the tax credit if he hoes not actually reside in the dwelling
for the required time period for reason of illness or need of special care may be qualified by
the Town Administrator.
GROSS INCOME - The total gross income from all sources, except social security
payments, including but not limited to gifts, and whether or not included in the definitions
of gross income for federal or state income tax purposes.
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THE COMMISSIONERS OF LEONARDTOWN

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Completed 23 January 2021

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