Form Pta 200 - Assessors' Certification Of Assessment
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1
2ASSESSORS’ CERTIFICATION OF ASSESSMENT
WE HEREBY CERTIFY, that the pages herein, numbered from ______________to ______________
inclusive, contain a list and valuation of Estates, Real and Personal, liable to be taxed in the
Municipality of _____________________________________ for State, County, District, and
Municipal Taxes for the fiscal year ______________ to ______________ as they existed on the first
mm/dd/yy
mm/dd/yy
day of April 20_____.
IN WITNESS THEREOF, we have hereunto set our hands at __________________________, this
municipality
_________________ day of _____________________________, 20________.
________________________________________________
Municipal Assessor(s)
________________________________________________
________________________________________________
________________________________________________
________________________________________________
MUNICIPAL TAX ASSESSMENT WARRANT
State of Maine
Municipality__________________________ County_______________________
To___________________________________, Tax Collector
In the name of the State of Maine, you are hereby required to collect of each person named in the list
herewith committed to you the amount set down on said list as payable by that person.
Assessments:
1. County Tax
$____________________
2. Municipal Appropriation
$____________________
3. TIF Financing Plan Amount
$____________________
4. Local Education Appropriation
$____________________
5. Overlay Not to Exceed 5% of “Net To Be
Raised” (see tax rate calculation #16)
$____________________
6. Total Assessments
$____________________
Deductions:
7. State Municipal Revenue Sharing
$____________________
8. Homestead Reimbursement
$____________________
9. BETE Reimbursement
$____________________
10. Other Revenue
$____________________
11. Total Deductions
$____________________
12. Net Assessment for Commitment
$____________________
(line 6 minus line 11)
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