Hartford, MI · Van Buren County
Poverty Exemption Affidavit
This affidavit is completed by a resident who was not required to file income tax returns and submits it with a Poverty Exemption Application.
At a glance
- Issued by
- City of Hartford · Hartford, Van Buren County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- cityofhartfordmi.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This affidavit provides proof for a Poverty Exemption Application when the resident was not required to file federal or state income tax returns for the current or preceding tax year. It asks the signer to affirm residence at the principal residence and provide its address, then sign and date the form; it must accompany the application filed with the local unit.
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 or preceding tax year completes this affidavit.
How to submit it
Submit this affidavit with the Poverty Exemption Application 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 the statements by signing and dating the form.
How to submit this form
- 1
Download The Affidavit
Download the Poverty Exemption Affidavit.
- 2
Complete The Form
Enter the principal residence address and affirm that you reside there and were not required to file income tax returns for the stated tax years.
- 3
Gather Tax Documents
The form is for residents who were not required to file returns; it does not list any attachment to gather for this affidavit.
- 4
Submit With The Application
File the affidavit with the Poverty Exemption Application with the supervisor or board of review of the local unit where the property is located.
Frequently asked questions
- Do I need a notary for the Poverty Exemption Affidavit?
- No. The affidavit is signed without a notary; the signer swears and affirms the statements by signing and dating the form.
- Who should complete this affidavit?
- A resident applying for a Poverty Exemption who was not required to file federal or state income tax returns for the current or preceding tax year.
- How do I submit the Poverty Exemption Affidavit?
- Submit it with the Poverty Exemption Application to the supervisor or board of review of the local unit where the property is located.