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Motor Vehicle Excise Tax Abatement Application

2. Motor Vehicle Excise Abatement Application

6. Instructions
   To apply for an abatement (or refund if excise has been paid), complete this form and provide the specified documentation

   To apply for an abatement (or refund if excise has been paid), complete this form and provide the specified documentation

8. Abatement Applications MUST be received by the assessors within three years after the excise was due, or one year after the excise was paid, whichever is later. To preserve your right to appeal, you must file on time. By law, assessors may only act on late applications in limited circumstances where the excise is still unpaid and their decision in those cases is final.

   Abatement Applications MUST be received by the assessors within three years after the excise was due, or one year after the excise was paid, whichever is later. To preserve your right to appeal, you must file on time. By law, assessors may only act on late applications in limited circumstances where the excise is still unpaid and their decision in those cases is final.

10. Filing an application does not stay the collection of your excise bill. To avoid interest, charges and collection action, including non-renewal of your registration, you must pay the bill in full within 30 days of its issue date. You will receive a refund if an abatement is granted.

    Filing an application does not stay the collection of your excise bill. To avoid interest, charges and collection action, including non-renewal of your registration, you must pay the bill in full within 30 days of its issue date. You will receive a refund if an abatement is granted.

12. Note:
    You are NOT entitled to an abatement if you (1) cancel your registration and retain ownership of the vehicle, or (2) move to another Massachusetts city or town, during the calendar year. No excise may be reduced to less than $5.00. No abatement or refund of less than $5.00 may be made.

    You are NOT entitled to an abatement if you (1) cancel your registration and retain ownership of the vehicle, or (2) move to another Massachusetts city or town, during the calendar year. No excise may be reduced to less than $5.00. No abatement or refund of less than $5.00 may be made.

16. Bill Information:

18. Tax Year: *

19. Tax Date
    Tax Date

20. Issue Date
    Issue Date

21. Bill Number

23. Plate /Registration Number*

24. VIN

25. Vehicle Year*

27. Make*

28. Model*

32. Name*

    As Shown on Bill

34. Address*

    As shown on bill

36. City*

37. State*

38. Zip Code*

40. Email*

41. Phone

43. Mailing Address

    If Different

45. City

46. State

47. Zip Code

51. Reason you are applying for abatement*

    1. vehicle sold or traded
    2. vehicle stolen or total loss
    3. vehicle repossessed
    4. vehicle junked
    5. vehicle returned (Lemon Law)
    6. Moved from Gardner before January 1 of Tax Year
    7. Moved Out of State
    8. Exemption
    9. Other

53. If other, please explain

55. If "Moved from Gardner before January 1 of Tax Year" list move date
    If "Moved from Gardner before January 1 of Tax Year" list move date

57. If "Moved out of State," list move date
    If "Moved out of State," list move date

59. If "Exempt," list type of exemption

63. Supporting Documentation

    You must provide supporting documentation for the reason you are applying for abatement. See requirements below

65. Vehicle Sold or Traded
    Bill of sale AND plate return receipt from the Registry of Motor Vehicles or new registration form if plate transferred to another vehicle.

    Bill of sale AND plate return receipt from the Registry of Motor Vehicles or new registration form if plate transferred to another vehicle.

67. Vehicle stolen or total loss
    Police report or insurance settlement letter AND plate return receipt, C-19 Form (Affidavit of Lost or Stolen Plate from RMV) or new registration form

    Police report or insurance settlement letter AND plate return receipt, C-19 Form (Affidavit of Lost or Stolen Plate from RMV) or new registration form

69. Vehicle repossessed
    Notice from lienholder AND plate return receipt, C-19 Form or new registration

    Notice from lienholder AND plate return receipt, C-19 Form or new registration

71. Vehicle Junked
    Receipt from junk yard AND plate return, C-19 Form, or New Vehicle Registration

    Receipt from junk yard AND plate return, C-19 Form, or New Vehicle Registration

73. Vehicle returned (Lemon Law)
    Letter from Dealer certifying return AND plate return receipt or new registration

    Letter from Dealer certifying return AND plate return receipt or new registration

75. Moved from Gardner before January 1 of Tax Year
    Proof of residency before January 1 of Tax year of bill (e.g. utility bill, voter registration, lease) AND proof RMV was notified before January 1 of address change for registration. Note: You must notify the RMV within 30 days of moving and before January 1 to be billed by your new city or town next year

    Proof of residency before January 1 of Tax year of bill (e.g. utility bill, voter registration, lease) AND proof RMV was notified before January 1 of address change for registration. Note: You must notify the RMV within 30 days of moving and before January 1 to be billed by your new city or town next year

77. Moved out of state
    Registration from new state or country

    Registration from new state or country

79. Exemption
    Document establishing qualifications

    Document establishing qualifications

81. Other
    Appropriate supporting documentation

    Appropriate supporting documentation

85. Electronic Signature:*

    Signed under the penalties of perjury

86. Date:*
    Date:

90. Year

91. Bill Number

93. Valuation

94. Months Assessed

96. Excise Assessed

97. Abatement Allowed

99. Adjusted Excise

100. Certification Number

102. Date:
     Date:

103. Assessor's Signature

Leave This Blank:


105. 1. Receive an email copy of this form.
106. Email address

     This field is not part of the form submission.

107. Submit

* indicates a required field