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2. Sold	Bill of sale and plate return receipt or if the plate is transferred then a copy of registration form.
   Traded	Purchase agreement citing vehicle as trade-in and copy of new registration form or plate return receipt.
   Stolen or Total Loss	Insurance settlement letter showing conveyance of title to insurance company, with VIN # and date of loss and C-19 Form (Affidavit of Lost or Stolen Plate) from Registry of Motor Vehicles or if the plate is transferred then a copy of new registration form, or plate return receipt.
   Moved from Rockland	Proof of garaging prior to January 1 of year of bill. Copy of insurance policy (coverage selection page). You must notify the Registry within 30 days of the move. Note: Moving to another city or town does not entitle you to an abatement.
   Moved from Massachusetts	Registration form from the new state or county and plate return receipt.
   Junked Vehicle	Receipt from junkyard and plate return receipt or if plate transferred then a copy of new registration form.
   Repossessed Vehicle	Repossession letter with VIN # and repossession date and plate return receipt or if plate transferred then a copy of new registration form.
   Exempt	Proof of entitlement to the statutory exemption.

4. Instructions

   To apply for an abatement, or refund if excise has been paid, complete the following form and provide the specified documentation.

   Abatement applications must be received by the Assessors Office within 3 years after the excise was due, or 1 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.
    
    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 the issue date. You will receive a refund if an abatement is granted.
    
    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, and no abatement or refund of less than $5.00 may be made.

6. Full Name (as shown on bill)*
8. Address (as shown on bill) *
10. Mailing Address (if different)
12. Bill/Tax Year
14. Bill Number
16. Reason You Are Applying for an Abatement

    In order to submit this application, you are required to upload two documents.

    1. License Plate Document: Plate Return Receipt or if plate transferred a copy of new registration
    2. Vehicle Information Document: Bill of Sale, Trade in Agreement, Total Loss Letter, New state’s car registration, or Junkyard receipt
18. Acknowledgment*

    1. By checking this box, I confirm that I am ready to proceed and upload the 2 documents needed
20. What have you done with your license Plate?

    1. Cancelled
    2. Transferred to New Car
22. Upload License Plate Information*

    If Cancelled: Please Upload RMV Cancellation Receipt.

    If Transferred to different vehicle: Please Upload New Registration.

24. What have you done with your vehicle?*

    1. Sold
    2. Traded
    3. Stolen or Total Loss
    4. Moved From Rockland
    5. Moved From Massachusetts
    6. Junked
    7. Repossessed
    8. Exempt
26. Upload Vehicle Information*

    This Document must contain VIN and date of transaction.

28. Applicant Information

30. Applicant Full Name*
32. Applicant Phone Number*
34. Applicant Valid Email*
36. Disclaimers

    1. 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 the issue date. You will receive a refund if an abatement is granted.
    2. Electronic Signature - By checking this box, I do hereby certify, under the pains and penalties of perjury, that the information provided above is true and correct.
40. Message for Assessors' Staff
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field