HomeMy WebLinkAboutUntitled State Tax Form 214 Affidavit as to Time
of Sending Tax Bills
THE COMMONWEALTH OF MASSACHUSETTS
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City or Town
OFFICE OF THE COLLECTOR OF TAXES
I, Li tnnb�r( rYbc�K�� ,Collector of Taxes for the City/Town of
13c>r441 AKl. r' . in the County of ,hereby;make affidavit that on
C , 2'=t ,20'a l,I sent notice of the amount of his tax to each person assessed whose name appears on the
list of 20 G f pP Taxes
(Real Estate/Personal Property/Motor Vehicle Excise,etc.)
committed to the Collector of Taxes by the Board of Assessors with a warrant dated Jean 1-14h ,20'a ,
Each such notice was sent by mail postpaid,directed to the town where the assessed person resided on January 1,
20 o""'Z I. ,or,if such person resided in a city,directed,if possible,to the street and number of his residence.
IGc ector of Taxes
for the Ci own of 1-Sc.
THE COMMONWEALTH OF MAS ACHUSETTS
X ,SS O-f ,20aD.
On this-al day of J an ,20fore me,the undersigned notary public,personally appeared
(name of document signer),proved to me through satisfactory evidence of
identification,which were 1 V 1-4 ,to 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)(h wledge and belief.
Notary Public ustice o e ace PAi'�xjC.1A SIFFEPiE
• My commission expires �J , 20 p["4. � � ��R'OThnYPU�L!C
LOkt
COLLECTOR: COMPLETE ONLY ON DOR COPY ; ,',i; ` ;, ,
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Type of Bill: Preliminary • Actual ,
Payment System;
Quarterly Semi-Annual
Payment Due Dates(s):
(Revised 2/2015) See Reverse Side for Instructions
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