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City of Northampton, Massachusetts
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Eligibility Application for Senior Property Tax Work Off Program 2018

  1. City of Northampton Senior Property Tax Work Off Program Eligibility Application

    This application is not open for public inspection.

  2. THIS FORM MUST BE SUBMITTED WITH THE APPLICATION

  3. Please provide a copy of your 2016* Federal Tax Return - Pages 1 & 2

  4. If you did not file a Federal Tax Return for 2016, please provide copies from all income sources during calendar year 2016 such as: Social Security statement for 2016; copy of bank statement for 2016; copy of pension or retirement statement for 2016; copy of interest or dividend statement for 2016; other income statements.

  5. * Tax return filing will be verified with the Internal Revenue Service

  6. Maximum Work Off Credit Allowed per Household is $1,000.

  7. This application has been examined by me. Under the pains and penalties of perjury, I declare that to the best of my knowledge and belief, it and all accompanying documents and statements are true, correct and complete.

  8. Typing your name substitutes as signature for online submittal purposes.

  9. Disposition of Applicant (Assessors' use only)

  10. Reviewed by: _______________________________________ Date: ____________________

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