Request Form for Tax Information
                            TOWN OF RUTLAND TAX COLLECTOR'S OFFICE
                 (If requesting a Municipal Lien Certificate, please include a check for $50.00 per parcel)

For information regarding payments of any kind, please complete the following form and send to:
Tax Collector's Office, 250 Main Street, Rutland, MA 01543-1397

You must include a stamped, self-addressed envelope with your request.

Name____________________________________      Phone #______________________

Address__________________________________________________________________

Property Street Address_____________________________________________________

Signature (required)_________________________________________________________

              Real Estate Tax - for Calendar Year ____________

              Parcel ID (on RE bill or Assessor's Web Site) __________________________

              Assessed Owner of Property ________________________________________

The Collector's Office shows the following payment information:
             Date Paid            Amount                     Date Paid           Amount                 Staff Initial

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

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                Motor Vehicle Excise Tax for Calendar Year __________

Exact name of owner of vehicle (s)_____________________________________________________
               
                                      Vehicle # 1                   Vehicle # 2                           Vehicle # 3

Make & Year ______________________________________________________________________

Plate # ___________________________________________________________________________

Payment Received__________________________________________________________________