TRURO TAXATION AID COMMITTEE



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TRURO TAXATION AID COMMITTEE Elderly and Disabled Fund -- Fiscal Year 2016 -- Guidelines and Application** **Must be submitted by Thursday, December 31, 2015 All information supplied to the Committee will be held in the strictest of confidence and not be open for public inspection. TO: Town Treasurer, Truro Town Hall, PO Box 2012, Truro, MA 02666-2012 (Town Treasurer 508-349-7004 x14) (10/15/2015)

APPLICATION GUIDELINES This fund was established to provide taxation assistance for the elderly and disabled residents of Truro from volunteer contribution of its citizens on their real estate tax forms. The fund was authorized by vote of Annual Town Meeting, April 13, 1999, Article 13 (acceptance of Massachusetts General Law Chapter 60, Section 3D). The eligibility criteria for assistance from this fund, is as follows:! Applicant must own and occupy the real estate in Truro as his or her primary and sole residence. An applicant must be the titled owner of the property or hold a life estate in the property. If title is held by a trust, the applicant must be both a trustee and at least a 50% beneficiary of the trust in order to qualify. Applicant must also have resided in the Town and held title to the taxed property a full calendar year prior to submission deadline.! Applicant must be elderly or disabled. Elderly is defined as a person who is at least 65 years of age on or before July 1, 2015 for which aid is being requested. Disabled is defined as a person who is not able to work due to illness or accident and is currently receiving benefits from one or more of the following programs based on a determination of disability: Social Security Administration, SSI or Medicaid, Veterans Administration, Workers Compensation, or any other such program or agency providing public/financial assistance due to the disability.! Total yearly household income, including Social Security, must be less than $35,000 if single, or less than $45,000 if married. Fiscal 2016 Application TAC Page 1

APPLICATION PROCESS! Taxation aid assistance will be awarded on an annual basis.! Application forms will be available at Truro Town Hall, Truro Public Library, Truro Council on Aging, and on the Town of Truro website (www.truro-ma.gov).! Applications for Fiscal Year 2016 will be due no later than December 31, 2015, and must be accompanied, if filed, by a copy of your entire 2014 Federal Income Tax return and any supporting documents indicating disability benefit receipts.! Return completed Application to: Town Treasurer, Truro Town Hall, PO Box 2012, 24 Town Hall Road, Truro, MA 02666-2012! We suggest you first avail yourself of the exemptions offered by the Board of Assessors. These include exemptions for Veterans, Elderly, Blind and Widowed Spouse or Children (for complete list and detailed information contact the Board of Assessors). A home owner is NOT eligible for the Truro Elderly and Disabled Tax fund if they are eligible for a Clause 41A Property Tax Deferral. Under no circumstances will the total exemptions combined with the taxation aid assistance exceed the total of your current tax bill.! All information supplied to the Committee will be held in the strictest of confidence and not be open for public inspection.! In reviewing eligible applications, consideration will also be given to an applicant s overall financial situation as determined by value of other assets, personal property owned, living expenses and unusual financial hardship. DISTRIBUTION OF FUNDS! The funds will be disbursed on a needs basis, as determined by the Committee s application of the eligibility guidelines. Since the fund is replenished annually through voluntary contributions, no set dollar amount can be established for any particular year. If taxation aid assistance is awarded, it will be applied to the Fiscal Year 2016 tax bill and the applicant will be notified by mail. Fiscal 2016 Application TAC Page 2

APPLICATION TRURO ELDERLY AND DISABLED FUND Name Age Marital Status Nature of disability (if applicable) Address of Property Mailing Address Parcel ID (from tax bill) Phone No Assessed value of residence (from tax bill) Years owned Is this your Primary Residence? Yes No Primary Residence is defined on Page 1. If in Trust, list Trustee(s): A. TOTAL GROSS INCOME (page 4) B. TOTAL ESTIMATED ASSETS (page 4) C. TOTAL ESTIMATED VALUE Personal Property Owned (page 5) D. TOTAL EXPENSES (page 5) Have you applied for, or are you receiving, any other exemptions or financial assistance? If so, please explain: Are there any unusual or extraordinary circumstances affecting your financial situation that you wish to have considered with this application? If so, explain on page 6. DO YOU OWN ANY OTHER REAL ESTATE? Yes No If so, where is it located and what is the assessed value: Fiscal 2016 Application TAC Page 3

A. INCOME (GROSS) ANNUAL COMMENTS Wages, salary or business revenue: Social Security Retirement (Federal, MA & Political Subdivisions) Workers Compensation, Unemployment: Disability, Supplemental SSI: Interest & Dividends: Other Income: (Rent, IRA s, Trust Income, Annuities, etc.) Other (please specify): A. TOTAL GROSS INCOME B. ESTIMATED ASSETS Savings, Checking, Money Markets CD, Annuities, IRA s, 401K s Stocks, Bonds Mutual Funds Other investments (please specify) Total amount Total amount Total amount Total amount Total amount Total amount B. TOTAL ESTIMATED ASSETS Fiscal 2016 Application TAC Page 4

C. PERSONAL PROPERTY OWNED ESTIMATED VALUE Vehicles, Boats Jewelry, Art Antiques, Collections Other personal possessions of value C. TOTAL ESTIMATED VALUE D. EXPENSES ANNUAL COMMENTS Mortgage Payment Electric, Heating (gas & oil) Phone, Cable Food, Clothing Car Loans, etc Credit Cards Medical Bills (including prescription drugs) Insurance (Medical, Life) Insurance (House, Auto) Other (please specify): D. TOTAL EXPENSES NOTE: If filed, copy of 2014 Federal Tax Return must be submitted with this application Fiscal 2016 Application TAC Page 5

Unusual circumstances or additional comments: CERTIFICATION I certify that the information I have provided in this application (including supporting documentation) is complete and accurate. I understand that all information is subject to verification. I understand that if approved and the Town of Truro becomes aware of any fraudulent activity related to my application, my assistance will terminate and I will return all funds received to the Town of Truro within 120 days of notification of termination. I authorize the Town of Truro to obtain further information as necessary to complete the application process, verify accuracy of any information provided, or require additional information necessary to determine eligibility. SIGNATURE(S) DATE (Signed and submitted under the pains and penalties of perjury) For Taxation Aid Committee Use Only Date Denied: Taxation Aid Committee Final Action Date Granted: Amount: $ Fiscal 2016 Application TAC Page 6