Full Text
PTAX-343 Application for Disabled Persons’ Homestead Exemption Step 1: Complete the following information 1 Property owner’s name Street address of homestead property IL City State ZIP Daytime phone Send notice to (if different than above) 2 Name Mailing address City State ZIP Daytime phone 3 Provide your date of birth: Month Day Year 4 Write the assessment year you are requesting the Disabled Persons’ Homestead Exemption (DPHE). 5 Write the property index number (PIN) of the property for which you are filing this form. Your PIN is listed on your property tax bill or you may obtain it from your Chief County Assessment Officer (CCAO). If you are unable to obtain your PIN, attach a copy of the legal description. a PIN 6 Did you receive the DPHE on this property for the prior assessment year? Yes No Step 2: Complete eligibility information 7 Check your type of residence. Single-family dwelling Duplex Townhouse Condominium a Is the residence operated as a cooperative? Yes No b Is the residence a life care facility under the Life Care Facilities Act? Yes No c If Yes to a or b above, is the disabled person liable by contract with the owner(s) for payment of property taxes? Yes No 8 On January 1, were you the owner of record or did you have a legal or equitable interest in this property or did you have a life care contract with a facility under the Life Care Facilities Act? Yes No a If No, write when you acquired interest in this property: Month Day Year 9 On January 1, did you occupy this property as your principal residence? Yes No Step 3: Attach proof of ownership 12 Check the documentation you are attaching as proof you are the owner of record or have legal or equitable interest in the property. Deed Contract for deed Trust agreement Life care contract Lease Other written instrument Specify: Step 4: Sign below I state that to the best of my knowledge, the information on this application is true, correct, and complete. Property owner’s or authorized representative’s signature Month Day Year Year 10 On January 1, were you a resident of a facility licensed under the ID/DD (intellectually disabled/ developmentally disabled) Community Care Act, Nursing Home Care Act, or Specialized Mental Health Rehabilitation Act? Yes No If Yes, a write the name and address of the facility. b was this property occupied by your spouse? Yes No c did this property remain unoccupied? Yes No 11 On January 1, were you liable for the payment of real estate taxes on this property? Yes No Note: You may attach a separate sheet describing your specific factual situation. You must provide the documents listed on the back of this form as proof of your disability. See the section “What documentation is required?” on the back of this form. PTAX-343 (R-11/11) IL-492-4536 13 Write the date the written instrument was executed: Month Day Year 14 If known, write the date recorded and document number from the county records. Month Day Year Document number Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes. ---PAGE BREAK--- Form PTAX-343 General Information What is the Disabled Persons’ Homestead Exemption? The Disabled Persons’ Homestead Exemption (DPHE) (35 ILCS 200/15-168) provides an annual $2,000 reduction in the equal ized assessed value (EAV) of the property owned and occupied as the primary residence on January 1 of the assessment year by a disabled person who is liable for the payment of property taxes. Who is eligible? To qualify for the DPHE you must • be disabled or have become disabled during the assessment year cannot participate in any “substantial gainful activity by reason of a medically determinable physical or mental impairment” which will result in the person’s death or that will last for at least 12 continuous months), • own or have a legal or equitable interest in the property on which a single-family residence is occupied as your primary residence on January 1 of the assessment year, and • be liable for the payment of the property taxes. If you previously received the DPHE and now reside in a facility licensed under the ID/DD (intellectually disabled/developmen tally disabled) Community Care Act, Nursing Home Care Act, or Specialized Mental Health Rehabilitation Act, you are still eligible to receive the DPHE provided your property • is occupied by your spouse; or • remains unoccupied during the assessment year. If you are a resident of a cooperative apartment building or life care facility as defined under Section 2 of the Life Care Facilities Act you are still eligible to receive the DPHE provided you occupy the property as your primary residence and you are • liable by contract with the owner(s) of record for the payment of the apportioned property taxes on the property; and • an owner of record of a legal or equitable interest in the cooperative apartment building. Leasehold interest does not qualify for this exemption. What documentation is required? You must provide one of the following items to qualify for the DPHE. The proof of disability must be for the same year as the assessment year shown on Line 3 of this application. 1 A Class 2 Illinois Disabled Person Identification Card from the Illinois Secretary of State’s Office. Class 2 or Class 2A qualifies for this exemption. Class 1 or 1A does not qualify. 2 Proof of Social Security Administration disability benefits which includes an award letter, verification letter or annual Cost of Living Adjustment (COLA) letter (only COLA Form SSA-4926- SM-DI). If you are under the age of 65 receiving Supplemental Security Income (SSI) disability benefits, proof includes a letter indicating SSI payments (COLA Forms SSA-L8151, SSA-L8155, or SSA-L8156). 3 Proof of Veterans Administration disability benefits which includes an award letter or verification letter indicating you are receiving a pension for a non-service connected disability. 4 Proof of Railroad or Civil Service disability benefits which includes an award letter or verification letter of total (100%) disability. 5 If you are unable to provide any of the items listed above as proof of your disability, each year you must submit Form PTAX 343-A, Physician’s Statement for Disabled Persons’ Homestead Exemption to your Chief County Assessment Offi cer (CCAO). This form must be completed by a physician. You may be required to provide additional documentation. You are responsible for any physicians’ costs. Can I estimate the amount of my exemption? Yes. Multiply the $2,000 reduction in EAV by the total tax rate shown on your most recent property tax bill. Example: $2,000 EAV X 7% = $140 estimated exemption When will I receive my exemption? The year you apply for this exemption is referred to as the as sessment year. The County Board of Review while in session for the assessment year has the final authority to grant your exemp tion. If your exemption is granted, it will be applied to the property tax bills that are paid the year following the assessment year. When and where must I file this Form PTAX-343? Contact your CCAO at the telephone number or address below for assistance and to verify your county’s due date. Note: To continue to receive this exemption, you must file Form PTAX-343-R, Annual Verification of Eligibility for Disabled Persons’ Homestead Exemption, each year with your CCAO. File or mail your completed Form PTAX-343: County, CCAO City IL ZIP If you have any questions, please call: Can I designate another person to receive a property tax delinquency notice for my property? Yes. Contact your CCAO for information on how to designate an other person to receive a duplicate of a property tax delinquency notice for your property. Are there other homestead exemptions available for disabled persons or disabled veterans? Yes. However, only one of the following disabled homestead exemp tions may be claimed on your property for a single assessment year • Disabled Veterans’ Homestead Exemption • Disabled Persons’ Homestead Exemption • Disabled Veterans’ Standard Homestead Exemption Official use. Do not write in this space. ( ) Date received:___ Verify Proof of Disability: 1 2 3 4 5 Expiration date:___ PTAX-343 (R-11/11) Mailing address Board of review action date: Approved Denied Reason for denial McLean 115 E Washington St Rm 101 PO Box 2400 Bloomington 61701 [PHONE REDACTED] Reset Print