MOTOR VEHICLE TAX CREDIT APPLICATION
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AA#________ MOTOR VEHICLE TAX CREDIT APPLICATION Sec. 12-71C Connecticut General Statutes For Vehicles Sold, Destroyed, or Stolen and Not Replaced. Date___________________ List Year___________ Account Number___________________ Name__________________________________ Address________________________________ __________________________________ ________________________________ __________________________________ ________________________________ Make___________ Year_____ Registration Number_______________ I.D._________________ Date vehicle was disposed of _________________________ Sold _______ Destroyed_______ **Re-registered out of State ______ Has this vehicle been replaced? Yes _____ No _____. A vehicle is considered replaced if another vehicle was purchased within 45 days and the same license plate was used. If YES, the total original July bill is due in full. If NO, you must include a copy of the plate return receipt with this form showing that the plate has been returned to the State D.M.V. _____________________ (Signature of Owner) The above named applicant deposes and says that the above statements are true and complete. ----------------------------------------------------------------- (Assessor’s Certification) Documentation verified __________ Supplemental List Checked__________ Number of taxable months ________ Original Assessments _______________________ X Percentage = Adjusted Assessment __________________________________ $________________ Linda I. Arnold, Town Assessor Note: In order to qualify for credit this form must be filled out and returned to this office along with acceptable proof verifying disposition of vehicle, by the end of the calendar year, two (2) years after the assessment date in which the credit situation occurred. For Example: October 1, 2005 = December 31, 2007 October 1, 2006 = December 31, 2008 ** Only proof acceptable is copy of registration in new State, by such person who concurrently ceases to be a resident of Connecticut. TOWN OF FARMINGTON ASSESSORS OFFICE FARMINGTON, CT 06032 APPLICATION FOR MOTOR VEHICLE PROPERTY TAX ADJUSTMENT BASED ON DMV “REGISTRATION PLATE RECEIPT” YEAR:_______ MAKE: _____________________ VEHICLE ID#:_________________ Registration Plate Number:_________________ I hereby apply for an adjustment to my motor vehicle property taxes based on the attached “Registration Plate Receipt” from the Connecticut Department of Motor Vehicles. I no longer own the above-described vehicle and I apply for a property Tax adjustment based on the date that I cancelled my vehicle registration, which is stated on the attached “Registration Plate Receipt.” I declare that the information supplied on this receipt and the information supplied by me above is true and complete. I declare that, I, in no way, have tried to evade property tax. By my signature below, I accept all responsibility for, and I agree to pay, all property taxes interest and penalties that result if the Town Assessor of the Town of Farmington receives documentation which shows that the information contained on this “Registration Plate Receipt”, or the information that I have provided above, is not accurate. Owner’s Signature:_________________________________ Date:__________________ (If signed by person other than the owner) Authorized by owner: PRINT NAME________________________ Phone:___________ Authorized Signature:________________________________ Date:_________________ -------------------------------------------------------- PLEASE NOTE: The DMV “Registration Plate Receipt” will not be acceptable if any of the following is missing from the “Registration Plate Receipt”. The receipt must clearly have: 1. Registration Plate Number 2. Cancellation was requested 3. Dates plates were returned and registration cancelled 4. Validated (stamped) by DMV Required Documentation For Motor Vehicle Assessment Changes Two Substantiating Documents must be submitted to the Assessor The documentation must be official and specific. Only these forms of proof are acceptable. NOTE: all forms of proof must be dated and specifically identify the vehicle in question by make, year and identification number (VIN). 1. Plate receipt from the Department of Motor Vehicles (DMV) indication that the vehicle’s registration has been cancelled, or the vehicle’s registration plate has been lost or stolen. 2. Any of the following in addition to the plate receipt from the DMV: (a) A copy of the vehicle’s bill of sale: A bill of sale section is now included on the bottom of the vehicle owner’s registration form and transfer information must be recorded on the back of said form before it is submitted to the DMV. It is, therefore, the seller’s obligation to provide a copy of the signed registration form along with the plate receipt to the assessor. (b) A copy of the vehicle’s Transfer of Title: The seller must provide the assessor with a copy of the signed Transfer of Title and the plate receipt. (c) Out of State Registration: Proof of residency in another state and a copy of the vehicle’s registration showing the date the vehicle was registered in that state, must be provided to the assessor along with the plate receipt. (d) Stolen Vehicle: A statement from the vehicle owner’s insurance company indicating that the vehicle was stolen and not recovered. The vehicle’s owner must file a lost or stolen plate form with the DMV, a copy of which must be provided to the assessor. (e) Totaled Vehicle: A statement from the vehicle owner’s insurance company indicating that the vehicle was totaled. If the vehicle’s owner did not return the plate to the DMV, he or she must file a lost or stolen plate form with the DMV, a copy of which must be provided to the assessor. (f) Junked Vehicle: A statement from the junkyard must be provided in addition to the plate receipt. (g) Trade-in Vehicle: A copy of the purchase agreement identifying the trade-in vehicle and its plate receipt must be provided to the assessor.