Application For Real Estate Tax Exemption Or Deferral And/or Personal Property Tax Relief Page 3
Download a blank fillable Application For Real Estate Tax Exemption Or Deferral And/or Personal Property Tax Relief in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Application For Real Estate Tax Exemption Or Deferral And/or Personal Property Tax Relief with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4NET COMBINED FINANCIAL WORTH (ASSETS) SECTION AS OF 12/31/06
(NOT INCLUDING PRINCIPLE RESIDENCE AND LOT UP TO TWO ACRES)
List of Assets
Applicant
Spouse
Relative1
Relative2
1 Cash on hand
2 Checking accounts
3 Savings accounts and money market funds
4 Savings certificates (CDs)
5 IRA, 401K or other retirement accounts
6 Stocks, bonds and/or mutual funds
7 Life insurance (cash value only)
8 Annuity (cash value only)
9 Other real estate owned (2006 assessed value)
2006 assessed value of qualified
10
Automobile(s)
vehicle
2006 assessed value of other
value
vehicle(s)
$0
$0
$0
$0
Total All Assets
$0
Add Total Assets for each column to arrive at Net Combined Worth:
Are you required to file or did you file a Federal Income Tax Return for 2006?
YES
NO
RESET FORM TO ERASE ALL DATA
CLICK TO PRINT FORM
PLEASE NOTE :
•
Please attach a photocopy of your 2006 Federal Income Tax Return to this application if you are required to
file. If it is not available when you file this affidavit, it must be submitted by April 20, 2007.
•
All applicants must also attach photocopies of supporting documents that will verify all sources of income. i.e.,
Social Security (SSA-1099), Railroad Retirement (RRB-1099), Pension (1099-R), W-2, interest income (1099-
INT), dividend income (1099-DIV), miscellaneous income (1099-MISC), etc.
•
Failure to submit all financial documentation by the due date will result in the denial of your application.
DECLARATION
I declare under the penalties provided by law that this affidavit, financial statement and any accompanying schedules,
have been examined by me and to the best of my knowledge and belief are true, correct, and complete. (Any person or
persons falsely claiming an exemption shall be guilty of a misdemeanor).
ANY PERSON SIGNING FOR AN APPLICANT
UNABLE TO SIGN FOR HIMSELF/HERSELF, MUST SIGN THE APPLICANT’S NAME AND PROVIDE THE NAME,
ADDRESS, AND TELEPHONE NUMBER OF THE PERSON ASSISTING THE APPLICANT (Signee)*
_______________________
______________
________________________________
___________
Your Signature
Date
Spouse’s Signature
Date
_______________________
______________
____________________________________
________________
(Signee Name)*
Date
Address
Telephone #
Page 3 of 4
ADVERTISEMENT
0 votes
Related Articles
Related forms
Application For Real Estate Tax Exemption For Elderly Or Permanently/totally Disabled Homeowners Form
Financial
Application For Real Estate Corporation, Partnership Or Limited Liability Company License Form 2000
Legal
Real Estate Tax Relief For Elderly And/or Totally Disabled Persons Application - City Of Alexandria - 2005
Financial
State Form 934 - Application For Real Estate License As Partnership Or D / B / A - State Of Indiana
Legal
Related Categories
Parent category: Financial