Affidavit Of Surviving Spouse Form printable pdf download

ID# ________________

AFFIDAVIT OF SURVIVING SPOUSE

RCVD BY: _________

FY: ________________

FOR PROPERTY TAX EXEMPTION

PURSUANT TO NEVADA REVISED STATUTE 361.080

I, the undersigned, hereby affirm that I am a bona fide resident of the State of Nevada (possess a

Nevada Driver’s License or Identification Card), and I meet all requirements for the exemption as

a surviving spouse, and that I have not claimed this exemption in any other county in the State of

Nevada.

A surviving spouse is not entitled to the exemption in any fiscal year beginning after his/her remarriage,

even if the remarriage is later annulled.

I wish to apply my exemption to: (Check Box Below)

(If choosing more than one, please split the amount for each, not to exceed the total of the exemption.)

To apply your exemption to your real property tax bill for July 1st, you must return the affidavit by June 15th, or for real

property acquired between June 15

and July 1

, you must return the affidavit by July 5th.

Exempt Amount

Real Property at the following location address or parcel number: _____________________

________

DMV/Governmental Services Tax (When registering vehicle you own)

________

Manufactured Home or Personal Property at the following location address or ID#_________

________

Please enclose a copy of your Nevada Driver’s License or ID card and a copy of spouse’s death certificate.

Note: This document must be signed before a Notary Public or a Deputy Assessor.

A person who files a false affidavit or proof and obtains an exemption is guilty of a gross misdemeanor.

Signature:

Date:

Print full name:

Name of spouse:

Mailing Address:

Phone:

Spouse’s date of Death:

STATE OF NEVADA

COUNTY OF _______________

On this ___day of ________________, ________ personally appeared before me, a Notary

Public ___________________________________personally known or proven to me the person

whose name is subscribed to the above instrument who acknowledged that ___he executed the

instrument. WITNESS my hand and official seal.

______________________________________________, Notary Public

Return this affidavit with required documentation to:

Michele W. Shafe, County Assessor, Customer Service Division, 500 S. Grand Central Parkway 2

Floor, Las Vegas, NV 89155-1403

Affidavit Of Surviving Spouse Form

Related Articles

Related forms

Related Categories