Form Ptr-2a -Verification Of 2001 Property Taxes For Property Tax Reimbursement Applicants printable pdf download

Form Ptr-2a -Verification Of 2001 Property Taxes For Property Tax Reimbursement Applicants

FORM PTR-2A

Homeowners

Verification of 2001 Property Taxes for

Property Tax Reimbursement Applicants

Social Security Number

–

Spouse’s Social Security Number

–

First Name

_________________________

Last Name _______________________________

Address

____________________________________________________________________

Block

_______________

Lot ___________

Qualifier ___________________________

2001 Property Taxes

1. Total Amount Paid

$_____________

2. Senior Citizenís Deduction $_____________

3. Veteranís Deduction

$_____________

4. Total Amount Due

$_____________

(Enter on Line 6, Form PTR-2)

I certify that I am the local tax collector of ________________________________,

where the above property is located. I further certify that the above stated amounts of

property taxes due and paid for calendar year 2001 are true and accurate to the best

of my knowledge. I have placed my stamp below for verification.

__________________________________________

(Name)

__________________________________________

(Title)

(If you complete this form, be sure to enclose it with your Form PTR-2 application)

Form Ptr-2a -Verification Of 2001 Property Taxes For Property Tax Reimbursement Applicants