Affidavit for Tax Exemption

AFFIDAVIT FOR TAX EXEMPTION

Disabled Veteran Exemption/

Specially Adapted Housing

Section 211.7b, as amended November, 2013 by P.A. 161 of 2013

Name:______

Parcel Number: 41-14-______

Property Address:______

I hereby claim exemption from real property taxes on the above property as allowed by P.A. 161 of 2013. I declare that I am an honorably discharged disabled veteran, or the unremarried surviving spouse of a deceased honorably discharged disabled veteran, and meet one or more of the following criteria set forth by the Act:

Have been determined by the United States department of veterans’ affairs to be permanently and totally disabled as a result of military service and entitled to veterans’ benefits at the 100% rate.
Have a certificate from the United States veterans’ administration, or its successors, certifying that he or she is receiving or has received pecuniary assistance due to disability for specially adapted housing.
Have been rated by the United States department of veterans’ affairs as individually unemployable.

(All required documentation must be attached to this affidavit for the initial request only)

Signed: ______

Date: ______

Assessor/Supervisor:

The above name Claimant appeared before me to claim full exemption from Real Property Taxes on his/her Homestead under Michigan Statute. I have verified claimant, or the deceased spouse of the unremarried claimant, was discharged under honorable conditions, owns or is purchasing the homestead for which he/she is claiming the exemption, and qualifies for the exemption under the criteria set forth by P.A. 161 of 2013. All supporting documentation is attached or on file.

Signed: ______Date: ______

Board of Review:

The Grand Rapids Township Board of Review does hereby grant the requested exemption for the following tax year based on the information provided.

Signed______Chairman, Board of Review

______Board of Review Member

Date: ______

TOWNSHIP OF GRAND RAPIDS, COUNTY OF KENT