Form Pa-35 - Assessing Officials' Response To Exemptions/tax Credits/deferral Application

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FORM
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
ASSESSING OFFICIALS’ RESPONSE TO EXEMPTIONS/
PA-35
TAX CREDITS/DEFERRAL APPLICATION
Property for which Exemption/Tax
NOTE: “CU PARTNER” STANDS FOR “CIVIL UNION PARTNER”
Credit/Deferral is claimed:
PROPERTY OWNER’S LAST NAME
FIRST NAME
INITIAL
STEP 1
NAME
AND
PROPERTY OWNER’S LAST NAME
FIRST NAME
INITIAL
ADDRESS
MAILING ADDRESS
CITY/TOWN
STATE
ZIP CODE
PROPERTY ADDRESS FOR WHICH EXEMPTION/CREDIT/DEFERRAL IS CLAIMED
CITY/TOWN TAX MAP #
BLOCK #
LOT #
STEP 2
EXEMP-
Date
VETERANS’ TAX CREDIT
Granted/Denied
TIONS/
TAX
Veterans’ Tax Credit $50 minimum (to $500)
Amount $
CRED-
Service Connected Total & Permanent Disability $700 minimum to $2000
Amount $
ITS/
Amount $
Surviving Spouse/CU Partner of Veteran Who Was
DEFER-
Killed or Who Died on Active Duty $700 minimum (to $2000)
RAL
Review Discharge Papers (ei: Form DD214), Form #
Other Information
Granted Denied
VETERANS’ EXEMPTION
Date
(b) Surviving Spouse/CU Partner
Total Exemption
(a) Veteran
APPLICABLE ELDERLY AND DISABLED EXEMPTION (OPTIONAL) INCOME AND ASSET LIMITS
Disabled Exemption
Elderly Exemption
Elderly Exemption Per Age Category
Income Limits
$
Single
$
65 - 74 years of age
$
$
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 $
Elderly & Disabled Tax Deferral
Granted
Denied
Amount $
Elderly and Disabled Tax Deferral
For Deferrals: This page must be returned to the property owner after approval or denial on or before July
1st following the date of Notice of Tax under RSA 72:1-d by fi rst class mail. (RSA 72:34,IV)
STEP 3
Municipal Comments/Notes
COM-
MENTS/
NOTES
Selectmen/Assessor(s) Printed Name
Signature of Selectmen/Assessor(s) in ink
Date
STEP 4
SIGNA-
TURES
APPEAL
If an application for a property tax exemption or tax credit is denied, an applicant may appeal in writing on or before September 1st
PROCE-
following the date of notice of tax under RSA 72:1-d to the New Hampshire Board of Tax and Land Appeals (BTLA) or to the Superior
Court. Example: If you were denied an exemption from your 2013 property taxes, you have until September 1, 2014, to appeal.
DURE
Forms for appealing to the BTLA may be obtained from the NH BTLA, 107 Pleasant Street, Concord, NH 03301, their web site at www.
nh.gov/btla or by calling (603) 271-2578. Be sure to specify EXEMPTION APPEAL.
PA-35
Rev. 3/2013

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