"TOWN OF CUMBERLAND PROPERTY TAX ASSISTANCE Senior Circuit Breaker Program"
TOWN OF CUMBERLAND PROPERTY TAX ASSISTANCE Senior Circuit Breaker Program Application Deadline- November 15, 2007 Name: ________________________________________________Age:__________ Property Address: ____________________________________________________ ____________________________________________________ Home Phone Number: _________________________________________________ Map and Lot Number (on Property Tax Bill):______________________________ If different than property address please provide mailing address: ________________________________________________________________________ ________________________________________________________________________ Please Check and Attach a Copy of Proof of Age: Driver’s License:_____ Birth Certificate: ______ Other:_________________ Please Describe Proof of Residency: Ownership __________ (Assessor to Verify) Rental __________ (Please provide copy of lease) Please attach a copy of your State Circuit Breaker Refund Check or confirmation. If you need any assistance with the completion of this form or the State form, please call Town Assessor, Bill Healey, at 829-2205 to schedule an appointment to review either or both forms. Remember only one of the property owners must be 70 years of age or older to qualify for this program. Please Return Form to: Mr. William Healey, Town Assessor Cumberland Senior Property Tax Relief 290 Tuttle Road Cumberland, Maine 04021