Form PA-1000 "Property Tax or Rent Rebate Claim" - Pennsylvania

What Is Form PA-1000?

Form PA-1000, Property Tax or Rent Rebate Claim, is a legal document filled out by Pennsylvania residents who wish to refund a portion of rent or property tax paid on their residence. You may file this claim if you owned or rented property and you or your landlord paid property taxes on this residence in 2019.

You are eligible for a property tax or rent rebate if you or your spouse residing in the same household are age 65 or older, you are a widow or widower, age 50 to 64, or you are permanently disabled, age 18 to 64. Additionally, your annual household income must be $35,000 and less if you are a property owner or $15,000 and less if you are a renter.

This form was released by the Pennsylvania Department of Revenue in May 1, 2020, with all previous editions obsolete. You can download a fillable Form PA-1000 through the link below.

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Form PA-1000 Instructions

State the following details in a PA-1000 Form:

  1. Indicate your and your spouse's social security numbers, full names, address, telephone number, and dates of birth. If your spouse is deceased, fill in the oval;
  2. Choose the reason for filing and certify your eligibility to submit the claim. You may state you are filing on behalf of a decedent;
  3. Provide a detailed breakdown of the income you and your spouse received during 2019. List the amount of social security benefits, pension, and annuities you received. Count interest and dividend income. Calculate the total amount of salaries, wages, gambling and lottery winnings, inheritances, and alimony you have received during the reporting year. You also need to report the insurance benefits and cash gifts of more than $300. Add the positive income amounts and submit proof of the income your report;
  4. If you file as a property owner, state your total 2019 property tax and property tax rebate. Attach copies of receipted tax bills;
  5. If you file as a renter, indicate how much rent you paid and the rent rebate amount;
  6. If you file as an owner/renter, enter the maximum rebate amount;
  7. Add your checking or savings account details to receive a direct deposit;
  8. State your total income amount and circle the appropriate rebate amount for your income level using the tables in the form;
  9. Print out the form, sign, and date it. The claim must also be signed by your spouse and two witnesses.

In addition to your claim, you also need to send photocopies of documentation that proves this claim - proof of your and your spouse's age, death certificate, proof of permanent disability and reported income, and documents that show property taxes and rents you or your landlord paid. In case you need more in-depth details to file your claim, you may use the official Form PA-1000 Instructions also provided by the Pennsylvania Department of Revenue.

PA-1000 Related Forms

Below you may find documentation to be attached to your claim and general guidelines that will help you to learn more about the Pennsylvania Property Tax/Rent Rebate Program:

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Download Form PA-1000 "Property Tax or Rent Rebate Claim" - Pennsylvania

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2005010059
PA-1000
Property Tax or Rent
Rebate Claim 05-20
(FI)
PA Department of Revenue
P.O. Box 280503
2020
Harrisburg PA 17128-0503
OFFICIAL USE ONLY
I
II
Check your label for accuracy. If incorrect, do not use the label. Complete Section I.
Fill in only one oval in each
If Spouse is
section.
Your Social Security Number
Spouse’s Social Security Number
Deceased, fill
START
1. I am filing for a rebate as a:
in the oval.
P. Property Owner – See
instructions
PLEASE WRITE IN YOUR SOCIAL SECURITY NUMBER(S) ABOVE
R. Renter – See instructions
Last Name
First Name
MI
B. Owner/Renter – See
instructions
2. I Certify that as of Dec. 31, 2020,
First Line of Address
I am (a):
A. Claimant age 65 or older
B. Claimant under age 65,
Second Line of Address
with a spouse age 65 or
older who resided in the
same household
C. Widow or widower, age
City or Post Office
State
ZIP Code
50 to 64
*
CODES
D. Permanently disabled
REQUIRED
and age 18 to 64
Spouse’s First Name
MI
County Code
School District Code
Country Code
*
*
3.
Filing on behalf of a
decedent
Claimant’s Birthdate
Spouse’s Birthdate
Daytime Telephone Number
MM/DD/YY
MM/DD/YY
Dollars
Cents
III
TOTAL INCOME received by you and your spouse during 2020
4.
4. Social Security, SSI and SSP Income (Total benefits $
divided by 2) . . . . . . . . . .
5.
5. Railroad Retirement Tier 1 Benefits (Total benefits $
divided by 2) . . . . . . . . . . .
6. Total Benefits from Pension, Annuity, IRA Distributions and Railroad Retirement Tier 2 (Do not
6.
include federal veterans’ disability payments or state veterans’ payments.) . . . . . . . . . . . . . . . . . . .
7.
7. Interest and Dividend Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LOSS
8.
8. Gain or Loss on the Sale or Exchange of Property. . . . . . . . . If a loss, fill in this oval. . . . .
LOSS
9.
9. Net Rental Income or Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . If a loss, fill in this oval. . . . .
LOSS
10.
10. Net Business Income or Loss . . . . . . . . . . . . . . . . . . . . . . . . . If a loss, fill in this oval. . . . .
Other Income.
11a.
11a. Salaries, wages, bonuses, commissions, and estate and trust income. . . . . . . . . . . . . . . . . . . . .
11b. Gambling and Lottery winnings, including PA Lottery winnings, prize winnings and the value
11b.
of other prizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11c.
11c. Value of inheritances, alimony and spousal support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11d. Cash public assistance/relief. Unemployment compensation and workers’ compensation,
11d.
except Section 306(c) benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11e. Gross amount of loss of time insurance benefits and disability insurance benefits,
11e.
and life insurance benefits, except the first $5,000 of total death benefit payments. . . . . . . . . . . .
11f. Gifts of cash or property totaling more than $300, except gifts between
11f.
members of a household. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11g. Miscellaneous income and annualized income amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11g.
12. Claimants with Federal Civil Service Retirement System Benefits enter $9,514 or $19,028.
See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12.
13. TOTAL INCOME. Add only the positive income amounts from Lines 4 through 11g and subtract
13.
the amount on Line 12. See Page 3 for income limitations. Enter this amount on Line 23. . . . . . . .
IMPORTANT: You must submit proof of the income you reported – See the instructions on Pages 7 to 9.
2005010059
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2005010059
PA-1000
Property Tax or Rent
Rebate Claim 05-20
(FI)
PA Department of Revenue
P.O. Box 280503
2020
Harrisburg PA 17128-0503
OFFICIAL USE ONLY
I
II
Check your label for accuracy. If incorrect, do not use the label. Complete Section I.
Fill in only one oval in each
If Spouse is
section.
Your Social Security Number
Spouse’s Social Security Number
Deceased, fill
START
1. I am filing for a rebate as a:
in the oval.
P. Property Owner – See
instructions
PLEASE WRITE IN YOUR SOCIAL SECURITY NUMBER(S) ABOVE
R. Renter – See instructions
Last Name
First Name
MI
B. Owner/Renter – See
instructions
2. I Certify that as of Dec. 31, 2020,
First Line of Address
I am (a):
A. Claimant age 65 or older
B. Claimant under age 65,
Second Line of Address
with a spouse age 65 or
older who resided in the
same household
C. Widow or widower, age
City or Post Office
State
ZIP Code
50 to 64
*
CODES
D. Permanently disabled
REQUIRED
and age 18 to 64
Spouse’s First Name
MI
County Code
School District Code
Country Code
*
*
3.
Filing on behalf of a
decedent
Claimant’s Birthdate
Spouse’s Birthdate
Daytime Telephone Number
MM/DD/YY
MM/DD/YY
Dollars
Cents
III
TOTAL INCOME received by you and your spouse during 2020
4.
4. Social Security, SSI and SSP Income (Total benefits $
divided by 2) . . . . . . . . . .
5.
5. Railroad Retirement Tier 1 Benefits (Total benefits $
divided by 2) . . . . . . . . . . .
6. Total Benefits from Pension, Annuity, IRA Distributions and Railroad Retirement Tier 2 (Do not
6.
include federal veterans’ disability payments or state veterans’ payments.) . . . . . . . . . . . . . . . . . . .
7.
7. Interest and Dividend Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LOSS
8.
8. Gain or Loss on the Sale or Exchange of Property. . . . . . . . . If a loss, fill in this oval. . . . .
LOSS
9.
9. Net Rental Income or Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . If a loss, fill in this oval. . . . .
LOSS
10.
10. Net Business Income or Loss . . . . . . . . . . . . . . . . . . . . . . . . . If a loss, fill in this oval. . . . .
Other Income.
11a.
11a. Salaries, wages, bonuses, commissions, and estate and trust income. . . . . . . . . . . . . . . . . . . . .
11b. Gambling and Lottery winnings, including PA Lottery winnings, prize winnings and the value
11b.
of other prizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11c.
11c. Value of inheritances, alimony and spousal support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11d. Cash public assistance/relief. Unemployment compensation and workers’ compensation,
11d.
except Section 306(c) benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11e. Gross amount of loss of time insurance benefits and disability insurance benefits,
11e.
and life insurance benefits, except the first $5,000 of total death benefit payments. . . . . . . . . . . .
11f. Gifts of cash or property totaling more than $300, except gifts between
11f.
members of a household. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11g. Miscellaneous income and annualized income amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11g.
12. Claimants with Federal Civil Service Retirement System Benefits enter $9,514 or $19,028.
See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12.
13. TOTAL INCOME. Add only the positive income amounts from Lines 4 through 11g and subtract
13.
the amount on Line 12. See Page 3 for income limitations. Enter this amount on Line 23. . . . . . . .
IMPORTANT: You must submit proof of the income you reported – See the instructions on Pages 7 to 9.
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2005110057
PA-1000 2020
05-20 (FI)
Your Social Security Number
START
Your Name:
PROPERTY OWNERS ONLY
14. Total 2020 property tax. Submit copies of receipted tax bills.
. . . . . . . . . . . . . . . . . . . . . . . . . . .
14.
15. Property Tax Rebate. Enter the maximum standard rebate
Compare this amount to line 14 and
amount from Table A for your income level here: (_______)
enter the lesser amount to the right.
15.
RENTERS ONLY
16. Total 2020 rent paid. Submit PA Rent Certificate and/or rent receipts . . . . . . . . . . . . . . . . . . . . . .
16.
17. Multiply Line 16 by 20 percent (0.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17.
18. Rent Rebate. Enter the maximum rebate amount
Compare this amount to line 17 and
from Table B for your income level here: (_______)
enter the lesser amount to the right.
18.
OWNER – RENTER ONLY
19. Property Tax/Rent Rebate. Enter the maximum
Compare this amount to the sum of
19.
rebate amount from Table A for your income
Lines 15 and 18 and enter the lesser
level here: (_______)
amount to the right.
DIRECT DEPOSIT.
Banking rules do not permit direct deposits to bank accounts outside the U.S. If your bank account is outside the U.S.,
do not complete the direct deposit Lines 20, 21 and 22. The department will mail you a paper check. If your rebate will be going to a bank
account within the U.S., you have the option to have your rebate directly deposited. If you want the department to directly deposit your rebate
into your checking or savings account, complete Lines 20, 21 and 22.
Checking
20. Place an X in one box to authorize the Department of Revenue to directly deposit your rebate
20.
into your: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Savings
21. Routing number. Enter in boxes to the right. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21.
22. Account number. Enter in boxes to the right. . . . . . . . . .
22.
TABLE A - OWNERS ONLY
TABLE B - RENTERS ONLY
INCOME LEVEL
Maximum
INCOME LEVEL
Maximum Standard
23.
Rebate
Rebate
Enter the amount from Line 13 of
$
0 to $ 8,000
$650
$
0 to $ 8,000
$650
the claim form on this line and circle
the corresponding Maximum Rebate
$ 8,001 to $15,000
$500
$ 8,001 to $15,000
$500
amount for your income level.
$15,001 to $18,000
$300
Owners use Table A and Renters
$18,001 to $35,000
$250
use Table B.
IV
An excessive claim with intent to defraud is a misdemeanor punishable by a maximum fine of $1,000, and/or imprisonment for up to one year
upon conviction. The claimant is also subject to a penalty of 25 percent of the entire amount claimed.
CLAIMANT OATH: I declare that this claim is true, correct and complete to the best of my knowledge and belief, and this is the only claim filed by
members of my household. I authorize the PA Department of Revenue access to my federal and state Personal Income Tax records, my PACE records, my
Social Security Administration records and/or my Department of Human Services records. This access is for verifying the truth, correctness and
completeness of the information reported in this claim.
Claimant’s Signature
Date
Witnesses’ Signatures: If the claimant cannot sign, but only makes a mark.
MM/DD/YY
Please sign the PA-1000 after printing.
Please sign the PA-1000 after printing.
1.
Spouse’s Signature
Date
Please sign the PA-1000 after printing.
Please sign the PA-1000 after printing.
2.
PREPARER: I declare that I prepared this return, and that it is to the best of my
Name of claimant’s power of attorney or nearest relative. Please print.
knowledge and belief, true, correct and complete.
MM/DD/YY
Preparer’s Signature, if other than the claimant
Date
Telephone number of claimant’s power of attorney or nearest relative.
Please sign the PA-1000 after printing.
(
)
Preparer’s Name. Please print.
Home address of claimant’s power of attorney or nearest relative. Please print .
Preparer’s telephone number
City or Post Office
State
ZIP Code
(
)
Claim filing deadline – June 30, 2021
You can call 1-888-728-2937 after June 1 to verify the status of your claim.
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