State Tax Form 96-3 - Blind Application For Statutory Exemption - 2009 Page 2
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2B. EXEMPTION STATUS. Complete the questions that follow.
Were you legally blind as of July 1,
?
Yes
No
Are you registered with Mass. Commission for the Blind?
Yes
No
If yes, give Certificate Number
Date Registered
Attach copy of certificate.
If no, attach a letter from your doctor indicating status as of July 1.
C. SIGNATURE. Sign here to complete the application.
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.
Signature
Date
If signed by agent, attach copy of written authorization to sign on behalf of taxpayer.
TAXPAYER INFORMATION ABOUT PERSONAL EXEMPTIONS
PERSONAL EXEMPTIONS. You may be eligible to reduce all or a portion of the taxes assessed on your domicile if you
meet the qualifications for one of the personal exemptions allowed under Massachusetts law. Qualifications vary, but
generally relate to age, ownership, residency, disability, income or assets.
You may be eligible for an exemption if you fall into any of these categories:
•
•
Blind
Minor child of deceased parent
•
•
Veteran with a service-connected disability
Senior citizen age 70 and older (65 and older by
•
local option)
Surviving spouse
More detailed information about the qualifications for each exemption may be obtained from your board of assessors.
WHO MAY FILE AN APPLICATION. You may file an application if you meet all qualifications for a personal exemption
as of July 1. You may also apply if you are the administrator or executor of a person who qualified for a personal
exemption on July 1.
WHEN AND WHERE APPLICATION MUST BE FILED. Your application must be filed with the Board of Assessors by
December 15 or 3 months after the actual bills were mailed for the fiscal year, whichever is later. An application is filed
when (1) received by the assessors on or before the filing deadline, or (2) mailed by United States mail, first class postage
prepaid, to the proper address of the assessors, on or before the filing deadline, as shown by a postmark made by the
United States Postal Service. THIS DEADLINE CANNOT BE EXTENDED OR WAIVED BY THE ASSESSORS FOR ANY
REASON. IF YOUR APPLICATION IS NOT TIMELY FILED, YOU LOSE ALL RIGHTS TO AN EXEMPTION AND THE
ASSESSORS CANNOT BY LAW GRANT YOU ONE.
PAYMENT OF TAX. Filing an application does not stay the collection of your taxes. In some cases, you must pay the tax
when due to appeal the assessors’ disposition of your application. Failure to pay the tax when due may also subject you
to interest charges and collection action. To avoid any loss of rights or additional charges, you should pay the tax as
assessed. If an exemption is granted and you have already paid the entire year’s tax as exempted, you will receive a
refund of any overpayment.
ASSESSORS DISPOSITION. Upon applying for an exemption, you may be required to provide the assessors with
further information and supporting documentation to establish your eligibility. The assessors have 3 months from the
date your application is filed to act on it unless you agree in writing before that period expires to extend it for a specific
time. If the assessors do not act on your application within the original or extended period, it is deemed denied. You will
be notified in writing whether an exemption has been granted or denied.
APPEAL. You may appeal the disposition of your application to the Appellate Tax Board, or if applicable, the County
Commissioners. The appeal must be filed within 3 months of the date the assessors acted on your application, or the date
your application was deemed denied, whichever is applicable. The disposition notice will provide you with further
information about the appeal procedure and deadline.
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