Northern Potter School District Occupational - Tax Form 80

To Whom it May Concern:

I attest that my 80th Birthday occurred on ___________ and I ask that both my school occupational and per capita tax be abted to $0 for the ___________year and all subsequent tax years.

This form must be returned or mailed to your respective Tax Collector by December 15 of the current tax year. Your Tax Collector address and contact information is located on your tax bill.

Each February for the current tax year the Northern Potter School Board of Directors will be presented with a List of Abatement requests to be approved.

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Applicant's Signature                                                Tax Collector's Signature at                                                                                 Approval Date

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Applicant's Twp or Borough                                        Date of Approval