Bureau of Taxation

Property Tax Division

Tel.287-2011

Application for Exemption from Local Taxation

WIDOW, MINOR CHILD OR WIDOWED MOTHER OF A VETERAN

1. Name ___________________________________________________________________

2. Legal Residence ___________________________________________________________

3. Do you Receive a Pension from the United Stales Government as the

a) Un remarried Widow or the Minor Child of a Veteran? _____Yes _____No

b) Un remarried Widowed Mother of a Veteran? _____Yes ______No

4. If Minor Child or Widowed Mother, Date of Birth _________________________

5. When was Residence in Maine LAST Established?_______________________

6. Information Relating to Deceased Veteran who was the Husband, Son or Parent of Applicant:

a) Name of Veteran ______________________________________________________

b) Date of Birth of Veteran________________________________________________________

c) Date of Decease of Veteran _____________________________________________

d) Was Veteran's Death Service connected? ____Yes _____No

e) Date of Entry into Armed Forces __________________________________

f) Legal Residence on Date of Entry into Armed Forces _______________________

g) Date of Discharge or Separation from Armed Forces _________________________

h) Was Veteran Receiving TOTAL Disability Pension or Compensation at Death? _______Yes _____ No

1. Did Veteran Receive a Grant from U.S. Government for Specially Adapted housing as a paraplegic? _______Yes ______No

i) Veteran's Administration Claim No. C ______________________________________________

j) Military Service Serial Number ___________________________________________________

Date ________________________ _________________________________________

Signature of Applicant

Bureau of Taxation

Property Tax Division

Tel.287-2011

INSTRUCTIONS: All questions must be answered. This application must be filed with the Assessor of the place where you reside on or before April 1 to be considered for this year. The Assessor shall thereafter grant such exemption while you are so qualified and continue a legal resident of that place. This application must be accompanied by satisfactory documentary evidence to support answers to questions. If you are m doubt as to the way in which to answer any question or as to documentary evidence needed, consult your Assessor.

___________________________________________________________________________________________________________

CERTIFICATE OF APPROVAL OF APPLICANT'S EXEMPT STATUS

Written proof of entitlement has accompanied this application which supports the statements here contained indicating that the applicant is entitled to exemption from property tax as indicated.

______ $ 5,000 Post W.W.I

_______$ 7,000 W.W.I.

_______ $47,500Paraplegic

In determining the local assessed value of the exemption, the assessor shall multiply the amount of the exemption by the ratio of current just value upon which the assessment is based.

Date Approved ___________________________________ Approved by _______________________________

Effective Date ____________________________________ Title ______________________________________

NOTE: Acceptable proof of entitlement is covered by, but not limited to V.A. Form 20-5455a when item 15 Tax Code indicates Code 2 or 3.

NOTE: when this form is used by a municipality the ratio to be used is that which was reported to the State Tax Assessor on the annual Municipal Valuation Return.

PTF-307

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