Ithaca, MI · Gratiot County
Poverty Exemption Affidavit
This affidavit is completed by a resident who was not required to file tax returns and submits it with an Application for Poverty Exemption.
At a glance
- Issued by
- City of Ithaca · Ithaca, Gratiot County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- ithacami.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This affidavit accompanies an Application for Poverty Exemption for a principal residence. It is for a person who was not required to file a federal or state income tax return for the current and preceding tax years. The form asks for the signer’s name, the principal residence address, signature, and date.
Who needs it
A resident applying for a Poverty Exemption who was not required to file federal or state income tax returns for the current and preceding tax years completes this affidavit.
How to submit it
Submit this completed affidavit with the Application for Poverty Exemption to the supervisor or board of review of the local unit where the property is located.
About notarization
This affidavit is signed without a notary; the signer swears and affirms by signing, and the document does not state that notarization is required.
How to submit this form
- 1
Download The Affidavit
Download the Poverty Exemption Affidavit PDF.
- 2
Complete The Form
Enter your name and the principal residence address, then sign and date the affidavit.
- 3
Gather Required Proof
Follow the application instructions for proof of eligibility, including tax return copies or affidavits for residents not required to file.
- 4
Submit With Your Application
Submit the affidavit with your Application for Poverty Exemption to the local unit supervisor or board of review.
Frequently asked questions
- Do I need a notary for the Poverty Exemption Affidavit?
- No. The form has a signature and date line and does not state that notarization is required. The signer swears and affirms by signing.
- Who should complete this affidavit?
- A person residing in the principal residence should complete it if they were not required to file federal or state income tax returns for the current and preceding tax years.
- How do I submit the Poverty Exemption Affidavit?
- Submit the completed affidavit with your Application for Poverty Exemption to the supervisor or board of review of the local unit where the property is located.
- What information does the affidavit ask for?
- The form asks for the signer’s name, the address of the principal residence, the signer’s signature, and the date.