B-276 REV. 5-2015 - Connecticut

1 NOTARIZATION (Not valid unless notarized below)Complete DATE OF SEPARATION at left, and submit separation papers to DMV for verification. You are exempt from the payment of registration fees only within two (2) years following the date of honorable discharge or OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLESOn The Web At FOR WAIVER OF REGISTRATION FEE - ACTIVE SERVICE IN ARMED FORCESB-276 REV. 5-2015 SIGNATURE OF APPLICANTXCT OPERATOR LICENSE FOR WAIVERFULL NAME AND MAILING ADDRESS OF ARMED FORCES UNIT (No Abbreviations)DATE OF SEPARATIONSIGNATURE OF COMMISSIONED OFFICERREGISTRATION NUMBERNAME OF APPLICANT (First Name, Middle Initial, Last Name)MOTORVEHICLEMARINEVESSELMAILING ADDRESS (No.)

2 , Street, Town, State) Connecticut RESIDENT ADDRESS (No., Street, Town - If same as above, write "SAME")HONORABLY SEPARATEDFROM ACTIVE SERVICEPRESENT ACTIVE SERVICEIN ARMED FORCESXPRINTED NAME & RANK OF COMMISSIONED OFFICERRANKIF NOT LICENSED IN CT, SPECIFY STATE ISSUING OPERATOR LICENSECHECK ONE FOR ACTIVE DUTY STATUSARMYNAVYMARINESAIR FORCEARMY or AIR NATIONAL GUARDINSTRUCTIONS: In order to qualify, YOU MUST HAVE BEEN A Connecticut RESIDENT AT THE TIME OF completed/signed/certified application indicating evidence of active duty with the armed forces of the United States. If Army orAir National Guard, or reservist, submit copy of your orders showing that you have been called to active duty in the armed forces of the United Stateswithin the registration period for which you are applying for fee waiver.

3 If HONORABLE DISCHARGE or SEPARATION, submit photocopy of yourseparation papers, and specify DATE OF SEPARATION below (SIGNATURE OF COMMISSIONED OFFICER IN CHARGE is not required).I certify under penalty of false statement that I was a legal resident of Connecticut or was at the time of induction, that I am on active duty or was honorably separated from service within the last two years, and that the information given on this application (and in any attachments) is true and certify that the above named applicant has provided evidence of military ID and is in the active service of the Armed Forces of the I further certify the applicant was a legal resident of Connecticut or was at time of OF APPLICATIONCOAST GUARDSec.

4 12-81. Exemptions. The following-described property shall be exempt from taxation: (53) Motor vehicle of member of armed forces. (a) One motor vehicle belonging to, leased to or held in trust for, any member of the United States armed forces, if such motor vehicle is garaged inside or outside the state; (b) Any person claiming the exemption provided under this subdivision for any assessment year shall, not later than the thirty-first day of December next following the date on which property tax is due in such assessment year, file with the assessor or board of assessors, in the town in which such motor vehicle is registered, written application claiming such exemption on a form approved for such purpose by such assessor or board.

5 Notwithstanding the provisions of this chapter, any person claiming the exemption under this subdivision for a leased motor vehicle shall be entitled to a refund of the tax paid with respect to such vehicle, whether such tax was paid by the lessee or by the lessor pursuant to the terms of the lease. Upon approving such person's exemption claim, the assessor shall certify the amount of refund to which the applicant is entitled and shall notify the tax collector of such amount. The tax collector shall refer such certification to the board of selectmen in a town or to the corresponding authority in any other municipality. Upon receipt of such certification, the selectmen or such other authority shall draw an order on the Treasurer in favor of such person for the amount of refund so certified.

6 Failure to file such application as prescribed herein with respect to any assessment year shall constitute a waiver of the right to such exemption for such assessment year;SUBSCRIBED ANDSWORN TO BEFORE ME:DATE SIGNEDXPLACE SWORNSIGNATURE OF DULY AUTHORIZED PERSON (C. G. S. 1-24)DATE COMMISSION EXPIRES OR JURIS NO.