FY2010

Town Of Pembroke

BOARD OF ASSESSORS

* * * * * * * * * IMPORTANT INFORMATION * * * * * * * *

　
TO FILE FOR PROPERTY TAX EXEMPTIONS

FOR

Elderly (age 70 by July 1, 2009) or Surviving Spouse or

Minor Child of a Deceased Parent

Clause 17D Exemption Amount $247.54

Basic Qualifications

Elderly Person

Applicant must be age 70 by July 1, 2009.

Must own and occupy subject property

on July 1, 2009 and for at least the

preceding FIVE years.

Surviving Spouse

Applicant must have been a widow or widower by July 1, 2009.

Must own and occupy subject property on July 1, 2009.

Minor Child (of a Deceased Parent)

Parent must have been deceased by July 1, 2009.

Applicant must own and occupy subject property on July 1. 2009.

Maximum Assets
The value of your assets, excluding your home, must not exceed

$55,785.

　

THE FOLLOWING INFORMATION MUST BE PROVIDED IN ORDER TO QUALIFY

COPIES OF:

1. Bank statements as of July 1, 2009

　

2. Income Tax Returns from previous year (2008) *

*NOTE: If you do not file an Income Tax Return please fill out the enclosed

form and mail or fax it to the Andover Address on the back of form

3. First Time Applicants must provide a copy of Birth Certificate