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Orange: BOE-261-GNT

Orange: BOE-261-GNT for 2016

DISABLED VETERANS’ EXEMPTION CHANGE OF ELIGIBILITY REPORT

SIGN HERE ONLY IF YOU NO LONGER QUALIFY FOR THE DISABLED VETERANS’ EXEMPTION AS OF JANUARY 1, 2016


I no longer qualify for the Disabled Veterans’ Exemption.

REASON AND DATE OF DISQUALIFICATION

(It is extremely important that you enter the date that you became ineligible.)


1.    The property is no longer my principal place of residence because:
A.    I sold the property on (date):
B.    I am still the owner of the property but I no longer reside there as of (date):


2.    I received the exemption as the surviving spouse of a deceased disabled veteran and I remarried on (date):


3.    My disability or disability compensation was changed to less than 100 percent on (date):


4.    I am no longer blind; visual acuity in both eyes was not rated at 5/200 or less, or have a concentric contraction of 5 degrees or less on (date):


5.    I have no longer lost the use of two limbs; use was restored on (date):


6.    Following a death, the property is no longer occupied by a qualified disabled veteran.
A. Name of deceased veteran:
B. Date of death:

Please attach a copy of the Death Certificate.

C. Name of person requesting change:  
D. Relationship to disabled veteran or unmarried surviving spouse:  
E. Daytime telephone number:
F. Signature