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T � WN �F LEXINGT � N <br /> APPLICATIDN FUR DEFERRAL 4F WATER and/or SEWER PAYMElvT <br /> (M.G.L. CHAPTER S3; SECT. 16G & CHAPTER 40; SECT. 42� <br /> Only those individuals defe��ing sor�e or all of their�eal estate taxes fo�the current fiscal�year <br /> a�e eligi�le fo�this defe��al. <br /> Deferral type requested: Water Sewer Both ' <br /> � v� � e���1 � ���� � ���� ��,..c� <br /> � � � <br /> Name s of Record v�mer `� `� <br /> � } o ................................. ........................ .........................�....................... <br /> • f�. �`-�� ����,�a . , <br /> Name of A licant.............�`..�..�....�....�:,.,.......�.�... ................................................................ <br /> pp �` , � <br /> Location of Real Esta�e u on which Water/ Sewer Deferral is claimed...�.��....�. .��:Y�.. ...��..... � <br /> � p � �� <br /> �� ��. <br /> ...................�-.�.�.�.�.............�.... .,..............�.�. ...................................,.................................. <br /> Has a Real Estate Tax Deferra� app�ication been f led for this propert�y for the current f scal year? <br /> � <br /> Yes No Date f�ed � � � 2Q� . <br /> !�,..�, d�1 <br /> � r �w�� � <br /> SUBSCRIBED THIS...............................day of.......... ........ ....................,24........ ER PENALTIES 4F PERJLTRY <br /> SIGNATURE APP . ��� � � <br /> ( LICANT) ... .............................. ....,..,..,.... ....... ................. ....... ......... <br /> � � � � ��, � � -� �.�.- ` � �� � °�� � <br /> � . � ���s � 1 � <br /> MAILINGADDRE S S.....................'.�........�.................3...................................................,......... <br />� THIS SPACE FUR ASSESS4I��' RECORD �NLY <br /> • �.P � f� n- . � � . . �' �S <br /> �� � <br /> PropertyLocatlon.......................... ........... ......................,............. Parcel ID............................... <br /> � a�C.p o�� • <br /> Date Real Estate Deferral Granted........ ........ ............... for F�scal Year ...�.�.� <br /> Pursuant to M.G.L. Ch. 83 Sect. 16G and Chapter 40 Sect. 42J this applicatxon for deferral of water and/or <br />� sewer chaxges is GRANTED � � DEI�TIED <br /> : .............................................................. . . <br /> .....•••............•..••...•....•.••.•..........•........... <br /> ; _ , • , ,., ,.., . !„ ._.. <br /> �''� . � . :•�����1�,�R�:�������������s�1��r�����1,�.����1����,�����f.��M�1�r����.i������ � ' <br /> •�������������������������f 1����������������������������1���• <br /> •����������������������������������������������1������������• <br /> sELECT Boa.� <br /> n�+A �n <br />