State Tax Form 214
State Tax Form 214 Affidavit as to Time
of Sending Tax Bills
THE COMMONWEALTH OF MASSACHUSETTS
City or Town
OFFICE OF THE COLLECTOR OF TAXES
I, _______________________________, Collector of Taxes for the City/Town of
____________________________ in the County of ____________________, hereby; make affidavit that on
_____________, 20____, I sent notice of the amount of his tax to each person assessed whose name appears on the
list of 20____. ___________________________________Taxes
(Real Estate/Personal Property/Motor Vehicle Excise, etc.)
committed to the Collector of Taxes by the Board of Assessors with a warrant dated _________________, 20___
Each such notice was sent by mail postpaid, directed to the town where the assessed person resided on January 1,
20____ , or, if such person resided in a city, directed, if possible, to the street and number of his residence.
___________________________Collector of Taxes
for the City/Town of _________________________
*********************************************************************************************
THE COMMONWEALTH OF MASSACHUSETTS
________________, SS _______________________, 20___
On this ____ day of ___________, 20__, before me, the undersigned notary public, personally appeared
________________________ (name of document signer), proved to me through satisfactory evidence of
identification, which were _______________________, to be the person who signed the preceding or attached
document in my presence, and who swore or affirmed to me that the contents of the document are truthful and
accurate to the best of (his) (her) knowledge and belief.
Notary Public/Justice of the Peace
My commission expires ________________, 20_______. *********************************************************************************************
COLLECTOR: COMPLETE ONLY ON DOR COPY
|Type of Bill: | | |Preliminary | | |Actual |
|Payment System; | | | | | | |
| | | |Quarterly | | |Semi-Annual |
|Payment Due Dates(s): | | | | | | |
(Revised 2/2015) See Reverse Side for Instructions
GENERAL INSTRUCTIONS - AFFIDAVIT AS TO TIME OF
SENDING TAX BILLS
The “affidavit as to time of sending tax bills” (state tax form 214) is a document prepared by the collector certifying the date tax bills were mailed and is prima facie evidence that the bills were mailed on that date.
It is strongly recommended that the collector prepare a separate affidavit of mailing for each property tax or excise bill mailing.
The original affidavit should be stamped, or in some manner authenticated, by the post office receiving the tax bills and should be notarized. The original affidavit should then be filed with the city or town clerk, with a copy retained for the collector’s records.
There is no requirement to send this document to the Bureau of Accounts.
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