New Hampshire Elderly and Disabled Property Tax Deferral Application

Elderly and Disabled Property Tax Deferral Application
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FOR REGISTER OF DEEDS USE ONLY

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FORM

NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION

PA-30

ELDERLY AND DISABLED TAX DEFERRAL APPLICATION

Reset Form

DUE MARCH 1 FOLLOWING THE NOTICE OF TAX
STEP 1
OWNER AND
APPLICANT
NAME
AND
ADDRESS

OWNER AND APPLICANT INFORMATION
If required, is a PA-33 on file?

OWNER

YES

NO

APPLICANT'S LAST NAME

APPLICANT'S FIRST NAME

MI

APPLICANT'S LAST NAME

APPLICANT'S FIRST NAME

MI

STREET ADDRESS
MAILING ADDRESS (if different from above)
CITY/TOWN

STEP 2
PROPERTY
LOCATION

STATE

PROPERTY LOCATION
STREET
CITY/TOWN
NUMBER OF ACRES

STEP 3
TO BE
COMPLETED
BY
PROPERTY
OWNER

ZIPCODE

COUNTY
TAX MAP

BOOK

LOT

BLOCK

PAGE

(a) Tax year for which the deferral is requested
(b) Amount of requested tax deferral
(c) Amount of tax bill
(d) Is the applicant:

YES

NO

65 or older and has owned homestead for five (5) consecutive years; or
Receives benefits under Title II or Title XVI of the Federal Social
Security Act and has owned homestead for one year; and
Living in the home?
STEP 4
OWNER
SIGNATURES

I understand that upon approval of this application by the municipal assessing officials, a lien shall be created against the above described property, pursuant to RSA 72:38a. My signature below indicates my agreement with the obligation incurred against the property described in Step 2 above. Under penalties of perjury, I declare that I have
examined this document and to the best of my belief the information herein is true, correct and complete.

TYPE OR PRINT NAME

SIGNATURE (IN INK)

DATE

TYPE OR PRINT NAME

SIGNATURE (IN INK)

DATE

TYPE OR PRINT NAME

SIGNATURE (IN INK)

DATE

TYPE OR PRINT NAME

SIGNATURE (IN INK)

DATE

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PA-30
Rev 12/2019

NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION

FORM

PA-30

STEP 5
APPROVAL BY
THE
MORTGAGEE

ELDERLY AND DISABLED TAX DEFERRAL APPLICATION
By signing below, the mortgagee signifies that they do approve and are duly notified that upon approval of this application by the municipal
assessing officials, a lien shall be created against the above described property, pursuant to RSA 72:38-a, III.

NAME OF MORTGAGE HOLDER

SIGNATURE OF OFFICER OR AGENT FOR MORTGAGEE

TITLE

DATE

TO BE COMPLETED BY MUNICIPAL ASSESSING OFFICIALS
STEP 6
AMOUNT OF
TAXES
DEFERRED

(a) Amount of tax deferred in prior years
(b) Amount of tax deferred in current year
(c) Total amount of taxes deferred [6(a) + 6(b)]

STEP 7
PERCENT OF
EQUITY VALUE
ENCUMBERED

(a) Enter the percentage of total equity value of the property encumbered in prior years
(b) Enter the percentage of total equity value of the property encumbered in current year
(c) Percentage of total equity value the property encumbered for: All Years [7(a) + 7(b)]

STEP 8
MUNICIPAL
DECISION

GRANTED DENIED

AMOUNT

DATE

Elderly Tax Deferral
Disabled Tax Deferral
For Deferrals: This page must be returned to the property owner after approval or denial, on or before July 1, following the date of Notice of
Tax as defined in RSA 72:1-d, by first class mail. (RSA 72:34, IV)
Reason
for Denial

STEP 9
APPROVAL OF
A MAJORITY OF
SELECTMEN /
MUNICIPAL
ASSESSING
OFFICIALS

PRINT / TYPE NAME OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

SIGNATURE (IN INK) OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

DATE

PRINT / TYPE NAME OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

SIGNATURE (IN INK) OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

DATE

PRINT / TYPE NAME OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

SIGNATURE (IN INK) OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

DATE

PRINT / TYPE NAME OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

SIGNATURE (IN INK) OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

DATE

PRINT / TYPE NAME OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

SIGNATURE (IN INK) OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

DATE

PRINT / TYPE NAME OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

SIGNATURE (IN INK) OF SELECTMEN / MUNICIPAL ASSESSING OFFICIAL

DATE

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PA-30
Rev 12/2019

NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION

FORM

PA-30

ELDERLY AND DISABLED TAX DEFERRAL APPLICATION

WHO MAY
FILE

Under the provisions of RSA 72:38-a, I, any resident property owner may apply for a tax deferral if they:
Are either at least 65 years of age or eligible under Title II or Title XVI of the Federal Social Security Act for benefits for the disabled; 
Have owned the homestead for at least five consecutive years if elderly or at least one year if disabled; and
Are living in the home.

WHEN TO
FILE

The completed Form PA-30 shall be filed by March 1 following the date of notice of tax. Example: If you are applying for a tax deferral
from your 2014 property taxes, which are due no earlier than December 1, 2014, then you have until March 1, 2015 to file this form.

WHERE TO
FILE

Once completed and signed in ink, this form shall be filed as follows:
Original: Register of Deeds
Copy:
To the Selectmen / Municipal Assessing Officials of the municipality of your primary residence
Copy:
Property Owner

TAX
DEFERRAL
PROVISIONS

The municipal assessing officials may annually grant a person qualified under this paragraph a tax deferral for all or part of the taxes due,
plus annual interest at five percent, if in their opinion the tax liability causes the taxpayer an undue hardship or possible loss of the
property. The total of tax deferrals on a particular property shall not be more than 85 percent of its equity value.
A tax deferral shall be subject to any prior liens on the property and shall be treated as such in any foreclosure proceedings.
If the property is subject to a mortgage, the owner must have the mortgage holder's approval of the tax deferral. Such approval does not
grant the town a preferential lien.

APPEALS

The municipal assessing officials shall send written notice advising the taxpayer of their decision to grant or deny the request for
exemption by July 1. Failure of the municipal assessing officials to respond shall constitute a denial of the application.
If an application for a property tax deferral is denied, an applicant may appeal in writing on or before September 1 following the date of
notice of tax under RSA 72:1-d, to the New Hampshire Board of Tax and Land Appeals (BTLA) or the County Superior Court in the
county where the property is located. Example: If you were denied a deferral from your 2014 property taxes, you have until September 1,
2015 to appeal.
Forms for appealing to the Board of Tax and Land Appeals may be obtained from the New Hampshire Board of Tax and Land Appeals,
107 Pleasant Street, Concord, NH 03301, by calling (603) 271-2578 or by visiting their website at www.nh.gov/btla. Be sure to specify
that you are appealing the Elderly or Disabled Tax Deferral application denial.

ADA
COMPLIANCE

Individuals who need auxiliary aids for effective communication in programs and services of the New Hampshire Department of Revenue
Administration are invited to make their needs and preferences known. Individuals with hearing or speech impairments may call TDD
Access: Relay NH 1-800-735-2964.

NEED HELP

Contact your local municipality or the Municipal and Property Division at (603) 230-5950; or visit the department's website at
www.revenue.nh.gov/forms.
LINE-BY-LINE INSTRUCTIONS

STEP 1

Enter the complete name and address of the property owner(s) requesting a tax deferral under RSA 72:38-a.

STEP 2

Enter the location, street address, municipality, county, number of acres, tax map, block and lot numbers, and book and page numbers of
the property for which the RSA 72:38-a, deferral is requested.

STEP 3

(a)
(b)
(c)
(d)

STEP 4

ALL property owners of record must type or print their full name, sign and date in ink, acknowledging that they understand and agree to
the obligation incurred against the property by electing a deferral of taxes under RSA 72:38-a. If there are more than four owners, submit
a supplemental list of names and signatures.

STEP 5

Enter the name of the mortgage holder and obtain the signature of an authorized agent for the mortgage holder.

STEP 6

The municipal assessing officials shall complete this step.
(a) Enter the amount of taxes deferred in prior years.
(b) Enter the amount of tax requested for deferral in the current year.
(c) The total amount of the tax deferral (Step 6(a) plus Step 6(b)).

STEP 7

The municipal assessing officials shall complete this step.
(a) Enter the percentage of the total equity value encumbered under RSA 72:38-a in prior years.
(b) Enter the percentage of the total equity value encumbered under RSA 72:38-a in the current year.
(c) The percentage of the total equity value encumbered for all years combined (Step 7(a) plus Step 7(b)).
If the result of Step 7(c) exceeds 85 percent, this application will be denied pursuant to RSA 72:38-a, I.

STEP 8

The municipal assessing officials shall complete this step.
Check applicable box for type of tax deferral. Check whether tax deferral was granted or denied. If granted, enter dollar amount granted.
Enter date tax deferral was granted.

STEP 9

Signatures of a majority of the local Selectmen or municipal assessing officials on the lines provided indicates approval.

Enter the tax year for which the deferral is requested.
Enter the amount of the requested tax deferral.
Enter the amount of the tax bill for the year of this application.
Check the appropriate boxes to indicate that all of the qualification requirements have been met.

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PA-30
Rev 12/2019