Step 1 of 2 50% This is an online form. You can easily complete the form from any desktop computer, tablet or mobile device and submit it online. You will automatically receive a confirmation of receipt. If there are attachments, you can even do those online as well. If you do not have all the required documentation, the submission will not go through. Don't forget that if you have any questions or requests please don't hesitate to let us know. By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored. Name of Applicant Occupation Telephone NumberMarital Status Legal Residence (Domicile) on July 1, 2021 Legal Residence City/Town Legal Residence Zip Mailing Address (If different) Location of Property No. of Dwelling Units: 1 2 3 4 Other Did you Occupy the property on July 1, 2021 and for the prior 10 years? Yes No *** Please list the other properties you occupied during the last 10 years.*** Continue list on attachment in same format as necessaryAddress 1 Dates 1 Address 2 Dates 2 Have you been granted any exemption in any other city or town (MA or other) for this year? Yes No Name of city or town Amount Exempted PERSONS WITH INTEREST IN PROPERTY.Did you own the property on July 1, 2021 as Sole Owner Co-owner with Spouse Only Co-owner with others Was there a mortgage on the property as of July 1, 2021? Yes No Name of Mortgagee(s) Was the property subject to a life estate as of July 1, 2021? Yes No Name(s) of Remaindermen (person(s) receiving property after your death)Was the property subject to a trust as of July 1, 2021? Yes No *** Please attach trust instrument including all schedules.***Reason for Hardship Activated Military Personnel Unemployment Illness or Disability Other Activated Military Personnel Initially enlisted in the armed forces Military status changed to active duty Date of activation to active duty (attach copy of orders) Provide employment history over the last two years including employers dates salaries reasons for leavingProvide a detailed description of the physical or mental illness disability or impairmentProvide a detailed explanation. FAMILY ASSISTANCE. Complete this section if you are receiving any financial assistance from family members.Name 1 Relationship 1 Residence 1 Occupation 1 Wages 1 Assistance given 1 Name 2 Relationship 2 Residence 2 Occupation 2 Wages 2 Assistance given 2 Please upload any documentation relating to your application. Drop files here or Select files Max. file size: 50 MB.
