Applicaton For Maine Veteran Property Tax Exemption Page 3
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111.
Name
APPLICAT¡ON
FOR MAINE
VETERAN PROPERTY TAX
EXEMPTION
36 M.R.S.
S
653
Please
refer
to Bulletin #7 for
additional
information
-
this
application
is
confidential.
File
this
application, including
all
required attachments with your
town
by
April
1
.
2. Telephone
3.
Mailing
Address:
4.
Legal Residence
5. Date of
Birth
***************************************************************************************************************************
***************************************************************************************************************************
6.
Date
of Entry into Armed
Forces
7. Service Number/SSN
8.
Legal Residence
on Date of Entry into Armed Forces
9.
Date
of Discharge or Separation from Armed Forces:
10.
Check
the box that applies:
tr
I
am
62 or older (or receiving a non service-connected total disability pension) and served
in
the
U.S.
Armed Forces during an accepted war period.
tr
I
am
62 or older (or receiving a non service-connected total disability pension) and received
an
Armed
Forces Expeditionary
Medal.
I
receive
a service-related total disability pension from the U.S. Government
for:
tr
Service
in
the
U.S.
Armed Forces during
any Federally recognized War Period.
tr
lnjury or disease incured
in
the line of duty during active military service.
VA
disability pension Claim Number: C-
11.
Did
you receive a grant from the U.S. Government for specially adapted housing as a paraplegic?
trYes
trNo
12.
ls
the property
you are requesting an exemption for in a revocable living trust with you as the beneficial
owner of
that
trust? B
Yes
tr
No
13.
Entera description
of
the property (map, lot, location,
etc.):
I
hereby apply
for an exemption
from
property tax in accordance with 36 M.R.S.
S
653.
No property on which
I
claim tax
exemption as a veteran
was
conveyed
to me for the purpose of obtaining exemption other than from
my spouse. The
answers to the above
questions are conect to the
best
of my
knowledge and
belief.
Signature:
Date
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