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Annual Property Tax Deduction for Senior Citizens, Disabled Persons - Claim Form

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This document is a claim form (Form PTD) for a real property tax deduction in New Jersey for qualified resident senior citizens, disabled persons, or surviving spouses/civil union partners. To be eligible, applicants must meet specific criteria related to age, disability status, residency, income (not exceeding $10,000), and property ownership as of October 1 of the pretax year. The completed form must be filed with the municipal tax assessor between October 1 and December 31 of the pretax year or with the municipal tax collector between January 1 and December 31 of the calendar tax year.

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--- Document: Annual Property Tax Deduction for Senior Citizens, Disabled Persons - Claim Form Document ---
 
 
Property Administration 
 
 
 
Form PTD rev. 10/2019 
 
 
 
 
 
 
 
 
 
Page 1 of 4 
 
 
CLAIM FOR REAL PROPERTY TAX DEDUCTION ON DWELLING HOUSE OF QUALIFIED NEW JERSEY 
RESIDENT SENIOR CITIZEN, DISABLED PERSON, OR SURVIVING SPOUSE/SURVIVING CIVIL UNION 
PARTNER 
 
 (N.J.S.A. 54:4-8.40 et seq.; L.1963 c.172 as amended) (N.J.A.C. 18:14-1.1 et seq.); Civil Union Act PL 2006, c.103, effective 2/19/07 
 
IMPORTANT: File this completed claim with your municipal tax assessor or collector. (See instructions on reverse.)  
 
 
1.  CLAIMANT NAME  
_______________________________________________________________________________________________________ 
Name(s) of claimant owner(s) permanently residing in dwelling house.  
 
 
2.  DWELLING LOCATION  
_______________________________________________________________________________________________________ 
Street Address of resident owner claimant's dwelling.  
 
(Unit # if Co-op)  
_______________________________________________________________________________________________________ 
County & Municipality   
 
 
 
 
 
 
 
 
Claimant Phone Number 
 
_______________________________________________________________________________________________________ 
Block / Lot / Qualifier  
 
 
 
 
 
 
 
 
Claimant Email 
  
 
3. YEAR OF DEDUCTION This deduction is claimed for the tax year________________ (indicate tax year).  
 
 
4. CITIZEN & RESIDENT (Complete A & B)  
A. 
 I was a citizen of New Jersey as of October 1 of the pretax year, i.e., the year prior to the tax year for which 
deduction is claimed; and  
B. 
 I was also a legal or domiciliary resident of New Jersey for at least one year immediately prior to October 1 pretax 
year. See instructions 2 & 3.  
 
 
5. OWNER & OCCUPANT 
 I (my spouse/civil union partner and I, as tenants by entirety), solely owned, held title to above identified dwelling occupied 
as my (our) principal or permanent residence as of October 1 of the pretax year. See instructions 4 & 5. 
 
 
**Complete 5a only if partial owners  
_______________________________________________________________________________________________________ 
5a.  Name of part owner  
 
 
 
 
 
% ownership interest in property  
 
 
**Complete 5b only if resident-tenant shareholder in Cooperative or Mutual Housing Corporation 
 
_______________________________________________________________________________________________________ 
5b.  Corporation Name of Cooperative or Mutual Housing  
 
_______________________________________________________________________________________________________ 
Co-op/M.H. Corp. Street Address  
 
 
 
Municipality  
 
 
State 
 
$_____________________________   
 
 
Co-op 
Net Property Tax Amount for Unit 
 
 
 
Mutual Housing Corp. 
 


Property Administration 
Form PTD rev. 10/2019 
Page 2 of 4 
6. ANNUAL INCOME LIMIT (must be reaffirmed by March 1 following year for which deduction was given.)
During the tax year for which the deduction is claimed, I reasonably anticipate that my annual income (and that of my 
spouse/civil union partner combined) will not exceed $10,000 after a permitted exclusion of Social Security Benefits, or 
Federal Government Retirement/Disability Pension, or State, County, Municipal Government and their political subdivisions 
and agencies Retirement/Disability Pension. See instructions 6 & 8. 
7. BIRTH DATE - MARITAL/CIVIL UNION STATUS
A. Date of Birth_________________________________________________________
B. 
Single    
 Married/Civil Union Partner    
Surviving Spouse/Surviving Civil Union Partner 
Legally Separated/Divorced/Dissolutioned 
8.
SENIOR OR DISABLED CITIZEN OR SURVIVING SPOUSE/SURVIVING CIVIL UNION PARTNER
(Choose A, B, or C)
A. 
 I was age 65 or more years as of December 31, of the year prior to tax year for which deduction is claimed. 
B. 
 I was permanently and totally disabled and unable to be gainfully employed as of December 31 of the year prior 
to the tax year. ATTACH PHYSICIAN'S OR SOCIAL SECURITY DISABILITY OR NEW JERSEY COMMISSION 
FOR BLIND CERTIFICATE. 
C. 
 I was a surviving spouse/surviving civil union partner as of October 1 of the year prior to the tax year   and have 
not remarried/entered into a new civil union partnership. 
I was age 55 or more as of December 31 of the year prior to the tax year and at time of my spouse's/civil union 
partner’s death.  
**My deceased spouse/civil union partner at his or her death was receiving a 
 senior citizen's property tax deduction or a  
 permanently and totally disabled person's property tax deduction. 
9. REAL PROPERTY TAX DEDUCTION OTHER DWELLING
I (and my spouse/civil union partner) did not receive a senior or disabled citizen or surviving spouse/civil union partner (if
applicable) property tax deduction on another dwelling for the same tax year except on my (our) former home identified below
where I (we) resided from ________________month/year to _________________month/year.
_______________________________________________________________________________________________________ 
Street Address  
 
 
 
 
 
 
 
Municipality 
I certify the above declarations are true to the best of my knowledge and belief and understand they will be considered as if 
made under oath and subject to penalties for perjury if falsified. 
_______________________________________________________________________________________________________ 
Signature of Claimant   
 
 
 
 
 
 
Date 
OFFICIAL USE ONLY 
Block____________________ Lot__________________ Approved in amount of $________________ 
Age 
 Disability 
Surviving Spouse/Surviving Civil Union Partner of 
senior citizen or 
disabled person 
Assessor_______________________________________________________________Date___________________ 
Collector_______________________________________________________________Date___________________ 
SIGN


 
 
Property Administration 
 
 
 
Form PTD rev. 10/2019 
 
 
 
 
 
 
 
 
 
Page 3 of 4 
 
GENERAL INSTRUCTIONS 
 
1. APPLICATION FILING PERIOD - File this form with the municipal tax assessor from October 1 through 
December 31 of the pretax year, i.e., the year prior to the calendar tax year or with the municipal tax collector 
from January 1 through December 31 of the calendar tax year. For example, for a property tax deduction claimed 
for calendar tax year 2019, the pretax year filing period would be October 1 - December 31, 2018 with the 
assessor and the tax year filing period would be January 1 - December 31, 2019 with the collector.  
 
 
2.  ELIGIBILITY DATES - Eligibility for the property tax deduction is established in the year prior to the calendar tax year 
for which the deduction is claimed as follows:  
New Jersey Citizenship as of October 1 pretax year  
Property Ownership as of October 1 pretax year  
Residence in New Jersey and in Dwelling House as of October 1 pretax year and  
Residence in New Jersey for 1 year immediately prior to October 1 pretax year  
Senior Citizen Age 65 or more as of December 31 pretax year  
Permanent and Total Disability as of December 31 pretax year  
Surviving Spouse/Surviving Civil Union Partner Age 55 or more as of December 31 pretax year and at the time of 
spouse's/civil union partner’s death  
 
 
3.  CITIZEN & RESIDENT DEFINED - United States Citizenship is not required. Resident for purposes of this deduction 
means a claimant who was legally domiciled in New Jersey for one year immediately prior to October 1 of the pretax 
year. Domicile is the place you regard as your permanent home - the place you intend to return to after a period of 
absence. You may have only one legal domicile even though you may have more than one residence. Seasonal or 
temporary residence in this State, of whatever duration, does not constitute domicile. Absence from the State for a 12 
month period is prima facie evidence of abandonment of domicile.  
 
 
4.  RESIDENCE IN DWELLING HOUSE DEFINED - Residence in the dwelling house means the dwelling where a 
claimant makes his principal or permanent home. Vacation, summer or second homes do not qualify. Only one 
deduction may be received per principal residence regardless of the number of qualified claimants residing on the 
premises.  
 
 
5.  TENANCY BY ENTIRETY DEFINED - Tenancy by Entirety means ownership of real property by both husband and 
wife or civil union partners, as a single ownership, in joint title acquired after marriage/civil union partnership.  
 
 
6.  INCOME DEFINED & LIMITED - 
 
a.)  The income period is the same tax year as the tax year for which a deduction is claimed. 
b.)  A claimant must reasonably anticipate that income received during the tax year, including income of the 
claimant's spouse/civil union partner, will not exceed $10,000. Income of claimant's family members, other 
than spouse/civil union partner, should not be included as annual income.  
c.)  Income means all income received from whatever source derived including, but not limited to, salaries, wages, 
bonuses, commissions, tips, and other compensations before payroll deductions, all dividends, interest, 
realized capital gains, royalties, income from rents, business income, and in their entirety, pension, annuity 
and retirement benefits. Realized capital gains, except for capital gain from the sale or exchange of real 
property owned and used by the claimant as his principal residence, dividends, interest, pensions, annuities 
and retirement benefits must be included in full without deductions even though they may be wholly or 
partially exempt for Federal income tax purposes.  
EXCLUDABLE INCOME**Income can be excluded under ONE of the following three categories: Social Security 
Benefits or Federal Government Retirement/Disability Pension including Federal Railroad Retirement Benefits or 
State, County, Municipal Government and their political subdivisions and agencies Retirement/Disability Pension.  
 
NOTE:  In accordance with the Civil Union Act, eligibility guidelines that apply to married couples and surviving 
spouses apply equally to civil union couples and surviving civil union partners. 
 
 


 
 
Property Administration 
 
 
 
Form PTD rev. 10/2019 
 
 
 
 
 
 
 
 
 
Page 4 of 4 
 
7.  DOCUMENTARY PROOFS REQUIRED - Each assessor and collector may require such proofs necessary to establish 
claimant's deduction entitlement and photocopies of any documents should be attached to this form as part of application 
record. For example: AGE may be verified by birth certificate, baptismal record, family Bible, census record, marriage 
certificate, court record, Social Security record, military record or discharge, immigration document, insurance policy, 
DISABILITY may be verified by physician's certificate, Social Security document, New Jersey Commission for Blind 
certificate. SURVIVING SPOUSE/SURVIVING CIVIL UNION PARTNER by death certificate of decedent. OWNERSHIP 
by deed, executory contract for property purchase, last will and testament.  RESIDENCY by New Jersey driver's license, 
motor vehicle registration, voter's registration, State tax return.  
 
 
8.  ANNUAL POST-TAX YEAR INCOME STATEMENT REQUIRED - On or before March 1 of the year immediately 
following the tax year for which deduction was claimed or received, a claimant must file a Post-Tax Year Income 
Statement, Form PD5, confirming that annual income for the tax year did not exceed the $10,000 limit and that 
anticipated annual income for the current year will not exceed that limit and that all other eligibility prerequisites 
continue to be met. For example, the Post-Tax Year Income Statement filed by March 1, 2019 supports the claim for 
deduction for tax year 2018 by confirming 2018 income. Anticipated income would refer to income received in tax year 
2019 for the 2019 deduction. IF THIS INCOME STATEMENT IS NOT TIMELY FILED, DEDUCTION WILL BE 
DISALLOWED AND CLAIMANT WILL BE BILLED FOR THE DEDUCTION AMOUNT.  
 
 
9.  APPEALS - A claimant may appeal any unfavorable determination by the assessor or collector to the County Board of 
Taxation annually on or before April 1. 
 
 
This form is prescribed by the New Jersey Division of Taxation, as required by law, and may be reproduced for 
distribution, but may not be altered without prior approval.