Military Exemption Claim Form by wvd19904

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									                                                                                     Co #________

                                 TREASURER'S AFFIDAVIT

                CERTIFICATE OF MILITARY EXEMPTION CLAIMS
              2008 CLAIMS, PAYABLE IN FISCAL YEAR 2009 - 2010
                          Due by September 1, 2009


To the Iowa Department of Revenue:


I, ________________________ County Treasurer of ________________ County, Iowa, do hereby
certify that the attached information is a true and complete list of claims for Military Exemption Tax
Credits as allowed by the Board of Supervisors. Certified to me by the County Auditor; that the total
amount of dollars, for all taxing districts is $________________(100%); and that said amount has
been computed in accordance with Chapter 426A and 427 of the Code of Iowa.


Rate of Reduction used: 0.00%
Actual Military Exemption Tax Credit issued: $ _______________




____/____/20___       ________________________________________
Date                                 County Treasurer




                   Mail to:    Iowa Department of Revenue
                               Military Exemption Claims
                               PO Box 10465
                               Des Moines, IA 50306

                   Fax to:     515-281-3906

                   E-mail:     Joel.Gabrielson@iowa.gov


  (Make copies as needed)                                                            54-144 (7/22/09)

								
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