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Non-Resident Affidavit for Property Tax Exemption

  1. Last name/first name/middle initial
  2. Rank
  3. Branch
  4. Date of Birth
  5. hereby claim an exemption from person property taxation in
  6. accordance with provisions of §574 of the Service Members' Civil Relief Act of 1940, as amended. Having
  7. been duly sworn, I depose the following in support of my claim:
  8. 1. On or after October 1,
  9. year
  10. (hereinafter referred to as the
  11. assessment date), I was an active duty member of the United States Armed forces, attached to the
  12. following duty station in Connecticut:
  13. 3. My presence in Connecticut on the assessment date was solely as a result of my official military orders.
  14. 5. I have retained my domicile in said State without interruption throughout my service in the Armed Forces.
  15. 6. It is now, and was on the assessment date, my intention to return to the State of my domicile upon my separation or retirement from the United States Armed Forces.
  16. 7. On the assessment date, I lived in the State of Connecticut at:
  17. 8. My current address is the same as on the assessment date.
  18. If "No," current address:
  19. 9. I am (and was) married on the assessment date.
  20. 10. On the assessment date, I (and/or my spouse) owned the personal property described below, which
  21. was located in the City/Town of
  22. , Connecticut.
  23. Note: With respect to "Ownership," please enter the following code(s), as applicable:
    S - For property owned solely by serviceman;
    SP - For property owned solely by serviceman's spouse; or
    J - For property jointly owned by serviceman and his/her spouse.
  24. Motor Vehicle
    Including unregistered snowmobiles
  25. Year, Make, Model
  26. State & Plate Number
  27. Ownership
  28. Leave This Blank:

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