Download Lease Agreement Fax Cover Sheet for Free

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Ministry of Finance
Office of the Tax Commissioner
F.B. Perry Building, 40 Church Street, Hamilton HM 12
P.O. Box HM 1374, Hamilton HM FX
Phone (441) 297-7537 Fax: (441) 296-5406 Email: [email protected] Websites: and
Application for Exemption from Land Tax
I wish to apply for exemption from Land Tax on my home.
1. My full name is:
2. (i) Address :
(ii) Telephone Home: ____________Cell: ____________ Work: _______________
(iii) *The assessment no. is:
(iv) *The Annual Rental Value (A.R.V.) is: $
(v) My date of birth is:
*This information is shown on your Demand Note.
3. I certify that I am a Bermudian aged 65 years or over, and that I live in the above home. Please
tick whichever of the following applies:
I am the legal owner of the above property.
I have a lease agreement for three years or more.
Please attach a copy of documentary proof (i.e. passport, birth certificate, status certificate,
lease agreements, confirmation of current address e.g. recent utility bill etc.)
Signature Date:
For office use only:
Basis of documentary proof: ______________________________
Examined by: _____________________ Date: ______________
Lease Agreement Fax Cover Sheet
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