Military Exemption Form - Please print and return to:
COUNTY OF JAMES CITY
RICHARD W. BRADSHAW
COMMISSIONER OF THE REVENUE
P.O. BOX 283
WILLIAMSBURG, VIRGINIA 23187-0283
Phone: (757) 253-6695
Fax :(757) 253-6733
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Name & Address (please print) Account Number #___________
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RE: Current Year Leave and Earning Statement
Military personnel residing in
**Please notify this office in writing of any changes in military status or garage jurisdiction. The locality in which the vehicle is garaged and the date of the change is necessary for current account information.
Thank you,
Richard W. Bradshaw,
Commissioner of the Revenue
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Social Security Number Home of Record (State)
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Signature
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Date