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Senior Citizen, Disabled Person, or Surviving Spouse Tax Deduction Application

BID #: N/A

ISSUED: 5/1/1996

DUE: TBD

VALUE: TBD

100

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Executive Summary

This document is an application form for a property tax deduction for qualified New Jersey residents who are senior citizens, disabled persons, or surviving spouses. Applicants must meet specific criteria regarding New Jersey residency and citizenship, property ownership and occupancy as a principal residence, and annual income limits. The form details the eligibility requirements, including age and disability status as of specific dates relative to the tax year, and outlines the required documentation for verification. Applications must be filed annually with the municipal tax assessor from October 1 through December 31 of the pretax year, or with the municipal tax collector from January 1 through December 31 of the calendar tax year. An annual Post-Tax Year Income Statement (Form PD5) is also required by March 1 of the year following the deduction claim to re-affirm eligibility.

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--- Document: Senior Citizen, Disabled Person, or Surviving Spouse Tax Deduction Application Document ---
CLAIM FOR REAL PROPERTY TAX DEDUCTION ON DWELLING HOUSE OF QUALIFIED NEW JERSEY
RESIDENT SENIOR CITIZEN, DISABLED PERSON, OR SURVIVING SPOUSE
(N.J.S.A. 54:4-8.40 et seq.; L.1963 c.172 as amended)
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.
County & Municipality
Block/Lot/Qualifier
(Unit # if Co-op)
********************************************************************************************************
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 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
$
Net Property Tax Amount for Unit
***********************
Municipality
State
{ } Co-op
{} Mutual Housing Corp.
*************
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 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 AND MARITAL STATUS
A. Date of Birth
B. {} Single { } Married { } Surviving Spouse { } Legally Separated/Divorced
********************************************************************************************************
8. SENIOR OR DISABLED CITIZEN OR SURVIVING SPOUSE (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 as of October 1 of the year prior to the tax year and have not remarried. { } 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 death. **My deceased spouse 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) did not receive a senior or disabled citizen
or surviving spouse (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
**************
OFFICIAL USE ONLY - Block
{ } Age
Assessor
Form PTD rev. May 1996
Date
****
Lot
********************
Approved in amount of $
{ } Disability { } Surviving Spouse of { } senior citizen or { } disabled person
Date
FORM PTD
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 1997, the pretax year filing period
would be October 1 - December 31, 1996 with the assessor and the tax year filing period would be January 1 - December 31,
1997 with the collector.
2. ELIGIBILITY DATES - Eligibility for the property tax deduction is established 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 Age 55 or more as of December 31 pretax year and at the time of spouse'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, as a single
ownership, in joint title acquired after marriage.
6. INCOME DEFINED & LIMITED -
a.)
b.)
c.)
The income period is the same tax year as the tax year for which a deduction is claimed.
A claimant must reasonably anticipate that income received during the tax year, including income of the laimant's
spouse, will not exceed $10,000. Income of claimant's family members, other than spouse, should not be included as
annual income.
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.
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 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.
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, 1998 supports the claim for deduction for tax year 1997 by confirming
1997 income. Anticipated income would refer to income received in tax year 1998 for the 1998 deduction. IF THIS
INCOME STATEMENT IS NOT TIMELY FILED, DEDUCTION WILL BE DISALLOWED AND CLAIMANT WILL BE
BILLED FOR THE 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.
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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.