HomeMy WebLinkAbout2017 State Tax Form 214 Affidavit as to Time
of Sending Tax Bills
THE COMMONWEALTH OF MASSACHUSETTS
City or Town
OFFICE OF THE�COLLECTOR OF TAXES
Collector of Taxes for the City/Town of
T M1'IAe,�— in the Countyof � e ,hereby;make affidavit that on
/a 3 O ,20 /� ,I sent notice of the amount of his tax to each person assessed whose name appears on the
list of 20 / '7 . P)-C-l C__ Taxes
(Real Estate/Personal Property/Motor Vehicle Excise,etc.)
committed to the Collector of Taxes by the Board of Assessors with a warrant dated a ,20�
Each such notice was sent by mail postpaid,directed to the town where the assessed person resided on January 1,
20 15 ,or, if such person resided in a city,directed,if possible,to the street and number of his residence.
(1Collector of Taxes
for the City/Town of NU r,;�
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THE COMMONWEALTH OF MASSACHUSETTS
SS C- (. ' SS c_> 1 7.
On this �j D day of 20L7,before me,the undersigned notary public,personally appeared
\ _T; C41-s" (name of document signer),proved to me through satisfactory evidence of
identification,which were/f �(�,Q� cjg f,���4_je Zo be the person who signed the preceding or attached
document in my presence,and who swore or affirmed to me that the contents of the document are truthful and
accurate to the best of(his)(her)knowledge and b7* NOTARY
SUZANNEM. PELICH
PUBuC
Notary Public/Justice of the Peace COMMONWEALTH OF MASSACHUSETTS
My Comm.Expires May 27,2022
My commission expires a 20
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COLLECTOR:COMPLETE ONLY ON DOR COPY
Type of Bill: Preliminary Actual
Payment System;
Quarterly Semi-Annual
Payment Due Dates(s):
(Revised 2/2015) See Reverse Side for Instructions
[7u�►stM�rk'
9440 Kirby Drive
Houston TX 77054
Affidavit Notice of Official Mail Count
Summary of mailing dates and counts
Mailing provided for:Town of North Andover
Year Tax Bills Count Date Mailed
2016 3rd Quarter Actual Real Estate Tax Bill 9991 December 30,2016
2016 3rd Quarter Actual Personal Property Tax Bili 726 December 30,2016
f
Signature:
JCC
.��`��'p[ib� KELLY SALINAS
Notary Public,State of Taxes
COMM.Expires 01-10-2021
x'114 or PI Notary lD 128280786
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