Business Equipment Tax Exemption Application Form
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2Maine Revenue Services - Property Tax Division
Business Equipment Tax Exemption Application
(Title 36 § 691 – 700B)
This application must be filed every year with the municipal assessor no later than May 1st
Name of Business: _________________________________________________________________Type of Business_________________________________________________
Business Address:_________________________________________________________________ Account #_______________________________________________________
Name of Owner: ___________________________________________________________________
To be Completed by the
(See instructions on reverse page)
Assessor
Description of the Exempt Equipment
Purchased /
Current
Cost
Estimate
Physical Address of Equipment
TIF
BETE
Assessed
(please be specific)
Placed in
Age
or
of
(Leased Equipment Only)
(Y / N)
Eligible
Value
Service in Maine
Value
Current
(Y / N)
(Month / Year)
New
Value
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Applicant (or property owner) signature: Under penalties of perjury, I declare that I have examined
Assessor (or agent of the assessor) signature: Under penalties of perjury, I declare that I have examined
this application and accompanying schedules and, to the best of my knowledge and belief, they are
this application and accompanying schedules and, to the best of my knowledge and belief, they are true,
true, correct and complete. Declaration of preparer (other than applicant) is based on all the information
correct and complete.
of which the preparer has knowledge.
Applicant ____________________________________________________ Date ______________
Assessor (or Agent of the Assessor) Signature__________________________________________
Preparer ____________________________________________________ Date ______________
Date __________________________
Maine Revenue Services:
Rev. 3.2014
Page 1
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