Form 801b - Assessor Notification Property Claimed For More Than 12 Years - 2013
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1
2ASSESSOR NOTIFICATION
2013
PROPERTY CLAIMED FOR MORE THAN 12 YEARS
Form 801B
(page 1)
SEE INSTRUCTIONS
Municipal Code:
SECTION 1. Notice of Intent.
(see pages 6 and 7)
1. MUNICIPALITY OF _____________________________________________________________________________
Dear Assessor: Pursuant to 36 M.R.S.A. § 6653, you are hereby notifi ed that :
(applicant name)
intends to fi le an application with Maine Revenue Services for reimbursement of property tax associated with eligible
business property fi rst placed in service in Maine after April 1, 1995 for taxes assessed April 1, ____________.
SECTION 2. Schedule for Business Equipment Tax Reimbursement. (
Attach additional sheets if needed)
The eligible business property is situated at (street address, map & lot, account #, etc.):
Valuation components determined by the local tax assessors establish an essential basis for taxpayers wanting to participate
in this program. I am requesting that you provide information pertaining to the assessed value for eligible business property
in Column F and relevant assessment information in Section 3. Please enter the necessary information sorted by “Number
of Years Claimed” and return this schedule to me within 60 days or make this information available to me when the tax bills
are issued, whichever occurs later. I believe the following property constitutes eligible business property which is eligible for
reimbursement by the State of Maine.
A.
B.
C.*
D.
E.
F.
Property Description
State of Origin
Number
Original
Original
Assessed Value
Category
(if acquired
of Years
Assessment
Cost
(To be completed by
used)
Claimed
Year
local tax assessor.)
13
1. Machinery & Equipment ............
_______
________
$ ____________
$ _________
13
2. Furniture ....................................
_______
________
_____________
__________
13
3. Other ..........................................
_______
________
_____________
__________
4. TOTALS (for columns E & F, add lines 1, 2, and 3) ...................................
_____________
__________
.75
5. Value Limitation ............................................................................................................................
__________
6. Allowable Assessed Value (in column F, multiply line 4 by line 5) ................................................
__________
7. Machinery & Equipment ............
_______
14
________
_____________
__________
8. Furniture ....................................
_______
14
________
_____________
__________
9. Other ..........................................
_______
14
________
_____________
__________
10. TOTALS (for columns E & F, add lines 7, 8 and 9) ....................................
_____________
__________
.70
11. Value Limitation ............................................................................................................................
__________
12. Allowable Assessed Value (in column F, multiply line 10 by line 11) ............................................
__________
13. Machinery & Equipment ............
_______
15
________
_____________
__________
14. Furniture ....................................
_______
15
________
_____________
__________
15. Other .........................................
_______
15
________
_____________
__________
16. TOTALS (for columns E & F, add lines 13, 14 and 15) ...............................
_____________
__________
.65
17. Value Limitation .............................................................................................................................
__________
18. Allowable Assessed Value (in column F, multiply line 16 by line 17) .............................................
__________
* Form 801B is for property claimed more than 12 years. See instructions for this form.
Continued on next page
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