State Tax Form 96 - Senior-Surviving Spouse Or Minor-Veteran-Blind Fiscal Year Application For Statutory Exemption

Sep 19, 2026

State Tax Form 96 (Revised 11/2016) is an application for statutory tax exemption for eligible taxpayers in the Commonwealth of Massachusetts. It is intended for use with city or town assessors and is not open to public inspection. The form provides filing instructions, requires applicant identification and property/ownership details, explains that eligibility under multiple categories yields the greatest assistance, and includes assessor disposition fields. Sections gather blind status, veteran-related status, surviving spouse/minor information, senior eligibility, and related documentation timelines, including requirements tied to fiscal year deadlines.

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CategoryForms

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Pages5

Reading Time2 min

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SENIOR--SURVIVING SPOUSE OR MINOR--VETERAN--BLIND FISCAL YEAR APPLICATION FOR STATUTORY EXEMPTION

INSTRUCTIONS

A. IDENTIFICATION

DISPOSITION OF APPLICATION (ASSESSORS’ USE ONLY)

B. EXEMPTION STATUS

C. GROSS RECEIPTS FROM ALL SOURCES IN PRECEDING CALENDAR YEAR

State Tax Form 96 Revised 11/2016 The Commonwealth of Massachusetts Name of City or Town | 17 | 22 | 37 | 41 | 42&43 | | --- | --- | --- | --- | --- | | Assessors’Use only | | | | | | Date Received Application No. Parcel Id. | | | | | SENIOR--SURVIVING SPOUSE OR MINOR--VETERAN--BLIND FISCAL YEAR APPLICATION FOR STATUTORY EXEMPTION General Laws Chapter 59, § 5 THIS APPLICATION IS NOT OPEN TO PUBLIC INSPECTION (See General Laws Chapter 59, § 60) Return to: Board of Assessors Must be filed with assessors on or before April 1, or 3 months after actual (not preliminary) tax bills are mailed for fiscal year if later. INSTRUCTIONS: Complete all sections that apply. If you qualify under more than one category, you will receive the exemption that provides the greatest amount of assistance. Please print or type. A. IDENTIFICATION. Complete this section fully. | Name of Applicant | | | | --- | --- | --- | | Telephone Number Legal Residence (Domicile) on July 1, | Marital Status Mailing Address (If different) | | | No. Street City/Town Zip Code
Location of Property : No. of Dwelling Units: 1 2 3 4 Other ~~ ~~ | | | | Did you own the property on July 1, ? Yes No
If yes, were you: Sole Owner Co-owner with Spouse Only Co-owner with Others Was the property subject to a trust as of July 1, ? Yes No | | | | If yes, please attach trust instrument including all schedules.
Have you been granted any exemption in any other city or town (MA or other) for this year? Yes No If yes, name of city or town Amount exempted $ | | | DISPOSITION OF APPLICATION (ASSESSORS’ USE ONLY) | Ownership GRANTED
Occupancy DENIED
Status DEEMED DENIED
Income Assets
Date Voted/Deemed Denied Certificate No.
Date Cert./Notice Sent
Exemption: Clause | Assessed Tax $ Exempted Tax $
Adjusted Tax $
Board of Assessors

Date: | | --- | --- | FILING THIS FORM DOES NOT STAY THE COLLECTION OF YOUR TAXES THIS FORM APPROVED BY THE COMMISSIONER OF REVENUE B. EXEMPTION STATUS. Check the status that applies to you and complete the questions that follow. BLIND PERSON Were you legally blind as of July 1, ? Yes No Are you registered with Mass. Commission for the Blind? Yes No If yes, give Certificate Number Date Registered Attach copy of certificate. If no, attach a letter from your doctor indicating status as of July 1. IF NO OTHER STATUS APPLIES TO YOU, GO ON TO SECTION E | | VETERAN
VETERAN’S SPOUSE
VETERAN’S/SERVICEMEMBER’S/ NATIONAL GUARD MEMBER’S SURVIVING SPOUSE or SERVICEMEMBER’S SURVIVING PARENT | Veteran’s Name Was the property the veteran’s domicile as of July 1, ?
Yes No
If no, where does the veteran reside? Deceased Veteran’s/Servicemember’s/National Guard member’s Name
If first year of application, attach copy of death certificate.
If you are surviving spouse, have you remarried? Yes No | | --- | --- | --- | | Date Enlisted/Inducted Date Discharged Type of Discharge If first year of application, attach copy of discharge papers.
Military Decorations or Awards Did the veteran/servicemember/national guard member live in Massachusetts for at least 6 months before entering the service? Yes No If no, list places and dates where veteran or member lived during the last 6 years or if deceased, the 6 years before death (2 years if local option adopted-See Assessors)
Address Dates | | | | Continue list on attachment in same format as necessary. | | | | If yes to any of the next 2 questions and if first year of application,(1) attach documentationfrom U.S. Dept. of Veterans Affairs, branch of service or doctor and (2) list above places and dates where surviving spouse has lived during the last 6 years (2 years if local option adopted – See Assessors)
Was the servicemember or national guard member killed or presumed killed in a combat zone? Yes No
Was the servicemember’s or

FAQs

Who must file this statutory exemption application, and when is it due?

It must be filed with the Board of Assessors on or before April 1, or 3 months after actual tax bills are mailed for the fiscal year if later.

What does the application require in the identification section?

Applicants must complete identifying information, including applicant name, telephone number, legal residence (domicile) details, marital status, mailing address, property location, and ownership and trust-related questions.

If someone qualifies under more than one exemption category, which exemption applies?

The applicant receives the exemption that provides the greatest amount of assistance.

Sep 19, 2026

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