Step 1 of 3 33% 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. FY2024 (July 1, 2023-June 30, 2024) General Laws Ch. 59 Sec. 5 Senior Clause 41CName:(Required) Address:(Required) Phone:(Required)Parcel Id:(Required) Property upon which exemption is claimed:Marital Status:(Required) Date of Birth:(Required) Daytime Phone:(Required)Indicate Status(Required) Sole Owner Co-owner with spouse Co-owner with non-spouse Indicate your percent share: Did you Own and Occupy this property as your principle residence as of July 1, 2023?(Required) Yes No Is this property Subject to a Trust as of July 1, 2023?(Required) Yes No *** Please provide a copy of the “Schedule of Beneficiaries” from the trust documents.***The application will not be processed without Financial Statements and Tax Returns2022 Tax Returns Submitted. MUST BE ATTACHED(Required) Yes No ***FORM CANNOT BE SUBMITTED WITHOUT TAX RETURNS***IRS Form 4506T-States you do not file Income Tax. Returned Last Year Yes No Indicate Gross Receipts from all sources in Calendar Year 2023Social Security, Railroad Retirement Benefits, Employee Pension, Retirement Allowance from U.S., Massachusetts, or any municipal jurisdiction for Applicant and Spouse.Other pensions, retirement allowances for Applicant and SpouseWages, salaries, tips, other compensation and/or net profits from business or profession for Applicant and SpouseInterest and Dividends for Applicant and SpouseGain(s) from sale or exchange of real estate for Applicant and SpouseGain(s) from sale or exchange of other property for Applicant and SpouseRent and/or royalty income for Applicant and SpouseReceipts from other sources for Applicants and SpouseTotal Applicant and SpouseSocial Security, Railroad Retirement Benefits, Employee Pension, Retirement Allowance from U.S., Massachusetts, or any municipal jurisdiction for Co-Owner and Spouse.Other pensions, retirement allowances for Co-owner and SpouseWages, salaries, tips, other compensation and/or net profits from business or profession for Co-owner and SpouseInterest and Dividends for Co-owner and SpouseGain(s) from sale or exchange of real estate for Co-owner and SpouseGain(s) from sale or exchange of other property for Co-owner and SpouseRent and/or royalty income for Co-owner and SpouseReceipts from other sources for Co-owner and SpouseTotal Co-Owner and Spouse Copies of your July 1, 2023 financial statements for any of the below categories must be attached to this application Amount in bank accounts (Savings, Checking, Certificate of Deposit) for Applicant and SpouseValue of stocks, Bonds and Securities for Applicant and SpouseValue of other personal property (Example: Boat, Recreational Vehicle) for Applicant and SpouseTotal for Applicant and SpouseAmount in bank accounts (Savings, Checking, Certificate of Deposit) for Co-owner and SpouseValue of stocks, Bonds and Securities for Co-owner and SpouseValue of other personal property (Example: Boat, Recreational Vehicle) for Co-owner and SpouseTotal for Co-owner and SpouseIs this property larger than three (3) dwelling units?(Required) Yes No Is there any commercial/business use of this property? Yes No Are you the record owner of real estate in any other jurisdiction? Yes No Please complete the following if you answered YES to any part of the above questions If your principal residence exceeds three (3) dwelling units and produces income, complete below:Record Owner(s) of property: If applicant holds less than full ownership indicate ownership percentage: Assessed Value of property: If you own ANY OTHER real estate, other than your principal residence please answer the following:Location: Record Owner(s) of Property: If applicant holds less than full ownership indicate ownership percentage: Assessed Value of property: Please Upload ALL required documents(Required) Drop files here or Select files Max. file size: 50 MB. SignatureDate(Required) MM slash DD slash YYYY Daytime Phone(Required)
