Form Pa-29 - Permanent Application For Property Tax Credit/exemptions Page 2
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4NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
FORM
PA-29
PERMANENT APPLICATION FOR PROPERTY TAX CREDIT/EXEMPTIONS
TO BE COMPLETED BY CITY/TOWN ASSESSING OFFICIALS
MUNICIPAL AUTHORIZATION
VETERANS’ TAX CREDIT
CITY/TOWN TAX MAP #
BLOCK #
LOT #
Granted
Denied
Date
Veterans’ Tax Credit ($50 minimum to $500)
Amount $
Service Connected Total & Permanent Disability ($700 minimum to $2000)
Amount $
Amount $
Surviving Spouse of Veteran Who Was
Killed or Who Died on Active Duty ($700 minimum to $2000)
Review Discharge Papers (Form DD214), Form #
Other Information
VETERANS’ EXEMPTION
Granted Denied
Date
Total Exemption
(a) Veteran
(b) Surviving Spouse
APPLICABLE ELDERLY AND DISABLED EXEMPTION (OPTIONAL) INCOME AND ASSET LIMITS
Disabled Exemption
Elderly Exemption Per Age Category
Elderly Exemption
Income Limits
$
$
65 - 74 years of age
Single
$
$
Married
$
75 - 79 years of age
$
80 + years of age
$
Asset Limits
$
$
Single
$
$
Married
OTHER EXEMPTIONS
Granted
Denied
Date
Elderly Exemption
Amount $
Disabled Exemption
Amount $
Improvements to Assist the Deaf
Amount $
Improvements to Assist Persons with Disabilities
Amount $
Blind Exemption
Amount $
Deaf Exemption
Amount $
Solar Energy Systems Exemption
Amount $
Woodheating Energy Systems Exemption
Amount $
Wind-Powered Energy Systems Exemption
Amount $
A photocopy of this Form (Pages 1 & 2) or a Form PA-35 must be returned to the property owner after approval
or denial before July 1st.
The following documentation may be requested at the time of application in accordance with RSA 72:34, II:
List of assets, value of each asset, net encumbrance and net value of each asset.
*
Statement of applicant and spouse’s income.
*
Federal Income Tax Form.
State Interest and Dividends Tax Form.
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Property Tax Inventory Form fi led in any other town.
Documents are considered confi dential and are returned to the applicant at the time a decision is made on the application.
*
Municipal Notes
Selectmen/Assessor(s) Printed Name
Date
Signatures(s) of Approval (in ink)
PA-29
2 of 4
Rev. 3/2013
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