Form 801 - Assessor Notification - 2008

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801
ASSESSOR NOTIFICATION
Form
SECTION 1. Notice of Intent.
Municipal Code:
1A. MUNICIPALITY OF _ ___________________________________________________________________________
Dear Assessor: Pursuant to 36 M.R.S.A. § 6653, you are hereby notified that :
(applicant name)
intends to file an application with Maine Revenue Services for reimbursement of property tax associated with eligible
business property first placed in service in Maine after April 1, 1995 for taxes assessed April 1, ___________.
1B. Claimant is a:
Corporation
Partnership
Sole Proprietor
LLC
SECTION 2. Schedule for Business Equipment Tax Reimbursement. (
Attach additional sheets if needed)
The eligible business property is situated at (street address, map & lot, account #, etc.):
________________________________________________________________________________________________
Valuation components determined by the local tax assessors establish an essential basis for taxpayers wishing to participate
in this program. I am requesting that you provide information pertaining to the assessed value for eligible business property
in Column F and relevant assessment information in Section 3 on the reverse side. Please enter the necessary information
and return this schedule to me within 60 days or make this information available to me when the tax bills are issued, whichever
occurs later. I believe the following listed property constitutes eligible business property which is eligible for reimbursement
by the State of Maine.
A.
B.
C.
D.
E.
F.
Property Description
State of Origin
Number
Date Placed in
Original
Assessed Value
(if acquired
of Years
Service
Cost
(To be completed by
used)
Claimed
(month/year)
local tax assessor.)
1. __________________________
_______
______
__________
$ _____________
$ _____________
2. __________________________
_______
______
__________
______________
______________
3. __________________________
_______
______
__________
______________
______________
4. __________________________
_______
______
__________
______________
______________
5. __________________________
_______
______
__________
______________
______________
6. __________________________
_______
______
__________
______________
______________
7. __________________________
_______
______
__________
______________
______________
8. __________________________
_______
______
__________
______________
______________
9. __________________________
_______
______
__________
______________
______________
10. __________________________
_______
______
__________
______________
______________
11. __________________________
_______
______
__________
______________
______________
12. __________________________
_______
______
__________
______________
______________
13. __________________________
_______
______
__________
______________
______________
14. __________________________
_______
______
__________
______________
______________
15. __________________________
_______
______
__________
______________
______________
REV. 06/08

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