| MUST BE FILED WITH THE HARWICH BOARD OF WATER COMMISSIONERS NOT LATER THAN THE DUE DATE OF FIRST ACTUAL (NOT PRELIMNAY) TAX PAYMENT FOR FISCAL YEAR OF WHICH THE WATER CHARGE BECAME A PART. | |||
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| 20___ THE COMMONWEALTH OF MASSACHUSETTS TOWN OF HARWICH APPLICATION FOR ABATEMENT WATER USE CHARGE |
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To the Board of Water Commissioners: NAME OF APPLICANT __________________________________________________________________ MAILING ADDRESS ____________________________________________________________________ The above name person aggrieved by a Water use charge dated ________, 20__ hereby applies for an abatement NAME OF PERSON ASSESSED (OWNER) __________________________________________________ LOCATION AND DESCRIPTION OF PROPERTY - NO. OF STREET, PLAN, OR LOT AND AREA OF LAND DESCRIPTION MUST BE SUFFICIENTLY ACCURATE TO IDENTIFY THE PREMISES. ____________________________________________________________________________________________ WATER USE CHARGE _______________ ASSESSED $_______________ AMOUNT PAID $ _______________ CHARGE PAID BY ____________________________ ON ______________________, 20_____ IF THE APPLICANT IS NOT THE PERSON ASSESSED, WHAT IS THE APPLICANT'S INTEREST IN THE PROPERTY? |
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COMPLETE STATEMENT FOR THIS APPLICATION (ATTACH ADDITIONAL SHEET IF NECESSARY)________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ CONTENTIONS OF LAW RAISED (ATTACHE ADDITIONAL SHEET IF NECESSARY) ______________________________________________________________________________________________ SUBSCRIBED THIS __________ DAY OF _______________, 20___ UNDER PENALTIES OF PERJURY. |
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