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2. Motor Vehicle Excise Abatement Application
6. Instructions
   To apply for an abatement (or refund if excise has been paid), complete this form and provide the specified documentation
8. Abatement Applications MUST be received by the assessors within three years after the excise was due, or one year after the excise was paid, whichever is later. To preserve your right to appeal, you must file on time. By law, assessors may only act on late applications in limited circumstances where the excise is still unpaid and their decision in those cases is final.
10. Filing an application does not stay the collection of your excise bill. To avoid interest, charges and collection action, including non-renewal of your registration, you must pay the bill in full within 30 days of its issue date. You will receive a refund if an abatement is granted.
12. Note:
    You are NOT entitled to an abatement if you (1) cancel your registration and retain ownership of the vehicle, or (2) move to another Massachusetts city or town, during the calendar year. No excise may be reduced to less than $5.00. No abatement or refund of less than $5.00 may be made.
16. Bill Information:
18. Tax Year: *
19. Tax Date
    Tax Date
20. Issue Date
    Issue Date
21. Bill Number
23. Plate /Registration Number*
24. VIN
25. Vehicle Year*
27. Make*
28. Model*
32. Name*
    As Shown on Bill
34. Address*
    As shown on bill
36. City*
37. State*
38. Zip Code*
40. Email*
41. Phone
43. Mailing Address
    If Different
45. City
46. State
47. Zip Code
51. Reason you are applying for abatement*

    1. vehicle sold or traded
    2. vehicle stolen or total loss
    3. vehicle repossessed
    4. vehicle junked
    5. vehicle returned (Lemon Law)
    6. Moved from Gardner before January 1 of Tax Year
    7. Moved Out of State
    8. Exemption
    9. Other
53. If other, please explain
55. If "Moved from Gardner before January 1 of Tax Year" list move date
    If "Moved from Gardner before January 1 of Tax Year" list move date
57. If "Moved out of State," list move date
    If "Moved out of State," list move date
59. If "Exempt," list type of exemption
63. Supporting Documentation
    You must provide supporting documentation for the reason you are applying for abatement. See requirements below
65. Vehicle Sold or Traded
    Bill of sale AND plate return receipt from the Registry of Motor Vehicles or new registration form if plate transferred to another vehicle.
67. Vehicle stolen or total loss
    Police report or insurance settlement letter AND plate return receipt, C-19 Form (Affidavit of Lost or Stolen Plate from RMV) or new registration form
69. Vehicle repossessed
    Notice from lienholder AND plate return receipt, C-19 Form or new registration
71. Vehicle Junked
    Receipt from junk yard AND plate return, C-19 Form, or New Vehicle Registration
73. Vehicle returned (Lemon Law)
    Letter from Dealer certifying return AND plate return receipt or new registration
75. Moved from Gardner before January 1 of Tax Year
    Proof of residency before January 1 of Tax year of bill (e.g. utility bill, voter registration, lease) AND proof RMV was notified before January 1 of address change for registration. Note: You must notify the RMV within 30 days of moving and before January 1 to be billed by your new city or town next year
77. Moved out of state
    Registration from new state or country
79. Exemption
    Document establishing qualifications
81. Other
    Appropriate supporting documentation
85. Electronic Signature:*
    Signed under the penalties of perjury
86. Date:*
    Date:
Leave This Blank:


95. 1. Receive an email copy of this form.
96. Email address

    This field is not part of the form submission.

97. Submit

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