Rsa 79-A:10 Land Use Change Tax Abatement Application To Municipality Page 2
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4RSA 79-A:10 LAND USE CHANGE TAX ABATEMENT APPLICATION
SECTION A. Person(s) Applying (Owner(s)/Taxpayer(s))
Name:
Mailing Address:
Telephone Number: (Work)
(Home)
SECTION B. Representative if Other than Owner(s)/Taxpayer(s)
(Must Also Complete Section A)
Name:
Mailing Address:
Telephone Number: (Work)
(Home)
SECTION C. Property for Which Abatement is Sought
List the tax map and lot number and the actual street address of each property for which an
abatement is sought and include a brief description and the assessment. (Attach additional sheets
if needed.)
Tax Map & Lot
Address
Description
Assessment
SECTION D. LUCT Information
Change Date: __________ LUCT Amount: _________ Full value Assessment:
Event causing imposition of LUCT:
Change Date: __________ LUCT Amount: _________ Full value Assessment:
Event causing imposition of LUCT:
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