Senior Citizen Property Tax Credit Page 2
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1
2QUALIFICATIONS:
If you:
a
Are full partial owner of a single-family residential property in Woonsocket.
b. Are 65 years of age or older.
c. Have owned and occupied property in Woonsocket for one (1) year.
d
Are legally domiciled in the City of Woonsocket at present.
e
Have a combined (yourself & your spouse) gross income of $14,000 or less.
You may qualify for an exemption credit in the amount of $158.76 of taxes on such property.
ATTENTION:
You must file an application with the Tax Assessor every year, no later than January
31st to receive a property tax credit.
Name of Applicant (Owner or Part Owner)
Address (of qualified property)
Applicant’s Birthdate
Marital Status
Date Property Purchased
Name of Spouse
Spouse’s Birthdate
Your Social Security No.
Spouse’s Social Security No.
Do you share ownership of this
If yes, give names of other
property with anyone other than
owners & Your share %
your spouse? YES_____ NO_____
INCOME:
(If married, include income of spouse) during last completed calendar year from January
through December.
Wages
$
Capital Gains
$
Dividends
$
Gifts, Inheritances
$
Interest
$
Rents or Royalties
$
Social Security (FICA)
$
Farm Income
$
Pensions, Annuities,
Assistance from Family
$
Retirement Benefits
$
Other
$
Business Income
$
Subtotal
$
TOTAL INCOME
$
AFFIDAVIT
(To be signed only in presence of a qualified Notary)
The above-named applicant, being duly sworn, deposes and says that the above statements are true and
complete and claims exemption under the applicable provisions of the laws of the State of Rhode Island and
the ordinances of the City of Woonsocket. The above-named applicant is also aware of the penalty for
making false affidavit.
State of
County of
City of
Signature of Applicant
Rhode Island
Providence
Woonsocket
X
Subscribe and Sworn to before me:
Date
Signed (Notary Public)
AUTHORIZATION (The following space is for the Tax Assessor’s use only)
Date Application Received:
PLAT:
LOT:
FILE:
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