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City of Northampton, Massachusetts
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Eligibility Application for Senior Property Tax Work Off Program 2020

  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. PART A: ELIGIBILITY REQUIREMENTS

    Please answer the following questions:

  4. Are you at least 60 years of age?

  5. Are you a Northampton homeowner or current spouse of a Northampton homeowner?

  6. Are you a Veteran?

  7. Is your Northampton home your primary residence?

  8. Do you own any other properties in MA or any other state?

  9. Do you own and occupy the property for which you are seeking credit?

  10. Are you a City of Northampton employee?

  11. PART B: Qualifications

    Please list your skills & talents. Please list at least three skills.

  12. Please check off areas of proficiency:

  13. COMPUTER

  14. CUSTOMER SERVICE SKILLS

  15. Do you prefer to work outdoors if a positions is available?

  16. Do you drive?

  17. Do you have transportation to a work site?

  18. PART C: SENIOR ELIGIBILITY FINANCIAL INFORMATION

  19. (For all members of your household. See income eligibility guidelines.)

  20. Please provide a copy of your 2018* Federal Tax Return - Pages 1 & 2

  21. If you did not file a Federal Tax Return for 2018, please provide copies from all income sources during calendar year 2018 such as: Social Security statement for 2018; copy of bank statement for 2018; copy of pension or retirement statement for 2018; copy of interest or dividend statement for 2018; other income statements.

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

  23. Maximum Work Off Credit Allowed per Household is $1,500. This document must be signed.

  24. By signing below, I attest that my Northampton residence is my primary residence, and if I qualify for the Senior Property Tax Work-Off Program, I understand that what I earn can only be applied as a credit to my City of Northampton property tax. 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.

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

  26. ASSESSOR'S OFFICE USE ONLY

  27. Disposition of Applicant

  28. SENIOR SERVICES USE ONLY

  29. Disposition of Application

  30. PLACEMENT

  31. Leave This Blank:

  32. This field is not part of the form submission.