Form PTAX-343 Application for the Homestead Exemption for Persons With Disabilities - St. Clair County, Michigan

Form PTAX-343 is a Michigan Department of Treasury form also known as the "Application For The Homestead Exemption For Persons With Disabilities". The latest edition of the form was released in August 1, 2015 and is available for digital filing.

Download an up-to-date Form PTAX-343 in PDF-format down below or look it up on the Michigan Department of Treasury Forms website.

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PTAX-343
Application for the Homestead Exemption
for Persons with Disabilities
Step 1:
Complete the following information
1
________________________________________________
3
______/_____/____________
Provide your date of birth:
Property owner’s name
Month
Day
Year
________________________________________________
4
Enter the assessment year for which you are requesting this
Street address of homestead property
___ ___ ___ ___
exemption:
__________________________________ IL ___________
Year
City
State
ZIP
5
Enter the property index number (PIN) of the property for which
(_____)______-___________
_______________________
you are filing this form. Your PIN is listed on your property tax
Daytime phone
Email address
bill or you may obtain it from your Chief County Assessment
Send notice to (if different than above)
Officer (CCAO). If you are unable to obtain your PIN, attach a
copy of the legal description.
2
________________________________________________
a
Name
PIN ___________________________________________
________________________________________________
PIN is parcel number and can be found on the top right corner on property tax bill
6
Did you receive this exemption on this property
Mailing address
________________________________________________
in the prior assessment year?
Yes
No
City
State
ZIP
(_____)______-___________
_______________________
NOT REQUIRED
Daytime phone
Email address
Step 2:
Complete eligibility information
10
7
On January 1, were you a resident of a facility
Check your type of residence.
licensed under the ID/DD (intellectually disabled/
Single-family dwelling
Duplex
developmentally disabled) Community Care Act,
Townhouse
Condominium
Nursing Home Care Act, Specialized Mental
Other____________________________________________
Health Rehabilitation Act of 2013, or MC/DD (Medically
Complex for the Developmentally Disabled) Act?
a
Is the residence operated as a cooperative?
Yes
No
Yes
No
b
Is the residence a life care facility
If Yes,
under the Life Care Facilities Act?
Yes
No
a enter the name and address of the facility.
c
If Yes to a or b above, is the person with the
_________________________________________________
disability liable by contract with the owner(s)
_________________________________________________
for payment of property taxes?
Yes
No
b
was this property occupied by your spouse?
Yes
No
8
On January 1, were you the owner of record or
did you have a legal or equitable interest in this
c
did this property remain unoccupied?
Yes
No
property or did you have a life care contract
with a facility under the Life Care Facilities Act?
Yes
No
11
On January 1, were you liable for the payment
a
If No, enter when you acquired
of real estate taxes on this property?
Yes
No
______/_____/____________
interest in this property:
Month
Day
Year
Note: You may attach a separate sheet describing your
9
On January 1, did you occupy this
specific factual situation. You must provide the documents
property as your principal residence?
listed on the back of this form as proof of your disability. See the
Yes
No
section “What documentation is required?” on the back of
this form.
Step 3:
Attach proof of ownership
12
Check the documentation you are attaching as proof you are the
13
Enter the date the written
owner of record or have legal or equitable interest in the property.
______/_____/____________
instrument was executed:
Month
Day
Year
Deed
Contract for deed
14
If known, enter the date recorded and document number from the
Trust agreement
Life care contract
county records.
Other written instrument
Lease
______/_____/____________
______________________
____________________
Specify:
Month
Day
Year
Document number
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
This form is authorized in accordance with the Illinois Property Tax Code. Disclosure of this information is required.
Failure to provide information may result in this form not being processed and may result in a penalty.
PTAX-343 (R-08/15)
PTAX-343
Application for the Homestead Exemption
for Persons with Disabilities
Step 1:
Complete the following information
1
________________________________________________
3
______/_____/____________
Provide your date of birth:
Property owner’s name
Month
Day
Year
________________________________________________
4
Enter the assessment year for which you are requesting this
Street address of homestead property
___ ___ ___ ___
exemption:
__________________________________ IL ___________
Year
City
State
ZIP
5
Enter the property index number (PIN) of the property for which
(_____)______-___________
_______________________
you are filing this form. Your PIN is listed on your property tax
Daytime phone
Email address
bill or you may obtain it from your Chief County Assessment
Send notice to (if different than above)
Officer (CCAO). If you are unable to obtain your PIN, attach a
copy of the legal description.
2
________________________________________________
a
Name
PIN ___________________________________________
________________________________________________
PIN is parcel number and can be found on the top right corner on property tax bill
6
Did you receive this exemption on this property
Mailing address
________________________________________________
in the prior assessment year?
Yes
No
City
State
ZIP
(_____)______-___________
_______________________
NOT REQUIRED
Daytime phone
Email address
Step 2:
Complete eligibility information
10
7
On January 1, were you a resident of a facility
Check your type of residence.
licensed under the ID/DD (intellectually disabled/
Single-family dwelling
Duplex
developmentally disabled) Community Care Act,
Townhouse
Condominium
Nursing Home Care Act, Specialized Mental
Other____________________________________________
Health Rehabilitation Act of 2013, or MC/DD (Medically
Complex for the Developmentally Disabled) Act?
a
Is the residence operated as a cooperative?
Yes
No
Yes
No
b
Is the residence a life care facility
If Yes,
under the Life Care Facilities Act?
Yes
No
a enter the name and address of the facility.
c
If Yes to a or b above, is the person with the
_________________________________________________
disability liable by contract with the owner(s)
_________________________________________________
for payment of property taxes?
Yes
No
b
was this property occupied by your spouse?
Yes
No
8
On January 1, were you the owner of record or
did you have a legal or equitable interest in this
c
did this property remain unoccupied?
Yes
No
property or did you have a life care contract
with a facility under the Life Care Facilities Act?
Yes
No
11
On January 1, were you liable for the payment
a
If No, enter when you acquired
of real estate taxes on this property?
Yes
No
______/_____/____________
interest in this property:
Month
Day
Year
Note: You may attach a separate sheet describing your
9
On January 1, did you occupy this
specific factual situation. You must provide the documents
property as your principal residence?
listed on the back of this form as proof of your disability. See the
Yes
No
section “What documentation is required?” on the back of
this form.
Step 3:
Attach proof of ownership
12
Check the documentation you are attaching as proof you are the
13
Enter the date the written
owner of record or have legal or equitable interest in the property.
______/_____/____________
instrument was executed:
Month
Day
Year
Deed
Contract for deed
14
If known, enter the date recorded and document number from the
Trust agreement
Life care contract
county records.
Other written instrument
Lease
______/_____/____________
______________________
____________________
Specify:
Month
Day
Year
Document number
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
This form is authorized in accordance with the Illinois Property Tax Code. Disclosure of this information is required.
Failure to provide information may result in this form not being processed and may result in a penalty.
PTAX-343 (R-08/15)
Form PTAX-343 General Information
What is the Homestead Exemption for Persons with
you are receiving a pension for a non-service connected
Disabilities?
disability.
Proof of Railroad or Civil Service disability benefits which
The Homestead Exemption for Persons with Disabilities (HEPD)
(35 ILCS 200/15-168) provides an annual $2,000 reduction in the
includes an award letter or verification letter of total (100%) dis-
equalized assessed value (EAV) of the property owned and oc-
ability.
cupied as the primary residence on January 1 of the assessment
If you are unable to provide any of the items listed above
year by a person with a disability who is liable for the payment of
as proof of your disability, each year you must submit Form
property taxes.
PTAX 343-A, Physician’s Statement for the Homestead
Exemption for Persons with Disabilities to your Chief County
Who is eligible?
Assessment Officer (CCAO). This form must be completed
To qualify for the HEPD you must
by a physician. You may be required to provide additional
have a disability during the assessment year (i.e., cannot
documentation. You are responsible for any physicians’
participate in any “substantial gainful activity by reason of a
costs.
medically determinable physical or mental impairment” which
Can I estimate the amount of my exemption?
will result in the person’s death or that will last for at least 12
Yes. Multiply the $2,000 reduction in EAV by the total tax rate
continuous months),
shown on your most recent property tax bill.
own or have a legal or equitable interest in the property on
Example: $2,000 EAV X 7% = $140 estimated exemption
which single-family residence is occupied as your primary
residence on January 1 of the assessment year, and
When will I receive my exemption?
be liable for the payment of the property taxes.
The year you apply for this exemption is referred to as the as-
sessment year. The County Board of Review while in session for
If you previously received the HEPD and now reside in a facility
the assessment year has the final authority to grant your exemp-
licensed under the ID/DD (intellectually disabled/developmen-
tion. If your exemption is granted, it will be applied to the property
tally disabled) Community Care Act, Nursing Home Care Act,
tax bill that is paid the year following the assessment year.
Specialized Mental Health Rehabilitation Act of 2013,
or MC/DD
you are
(Medically Complex for the Developmentally Disabled) Act
When and where must I file this Form PTAX-343?
still eligible to receive the HEPD provided your property
Contact your CCAO at the telephone number or address below
is occupied by your spouse; or
for assistance and to verify your county’s due date.
remains unoccupied during the assessment year.
Note: To continue to receive this exemption, you must file
If you are a resident of a cooperative apartment building or life
Form PTAX-343-R, Annual Verification of Eligibility for the Homestead
care facility as defined under Section 2 of the Life Care Facilities
Exemption for Persons with Disabilities, each year with your CCAO.
Act you are still eligible to receive the HEPD provided you occupy
File or mail your completed Form PTAX-343:
the property as your primary residence and you are
_______________________________________ County, CCAO
Jennifer Gomric Minton,
St. Clair
liable by contract with the owner(s) of record for the payment of
the apportioned property taxes on the property; and
____________________________________________________
Disabled Persons' Department, 10 Public Square
an owner of record of a legal or equitable interest in the
IL
____________________________________________________
Mailing address
Belleville
62220
cooperative apartment building. Leasehold interest does not
City
ZIP
qualify for this exemption.
What documentation is required?
If you have any questions, please call:
(
)
You must provide one of the following items to qualify for the
(618) 825-2704
Can I designate another person to receive a property
HEPD. The proof of disability must be for the assessment year
tax delinquency notice for my property?
shown on Line 3 of this application.
Yes. Contact your CCAO for information on how to designate an-
A Class 2 Illinois Person with a Disability Identification Card
other person to receive a duplicate of a property tax delinquency
from the Illinois Secretary of State’s Office. Class 2 or Class
2A qualifies for this exemption. Class 1 or 1A does not
notice for your property.
qualify.
Are there other homestead exemptions available for
Proof of Social Security Administration disability benefits
a person with a disability?
which includes an award letter, verification letter or annual
Yes. However, only one of the following homestead exemptions may
Cost of Living Adjustment (COLA) letter (only COLA Form
be claimed on your property for a single assessment year
SSA-4926-SM-DI). If you are under full retirement age and
receiving Supplemental Security Income (SSI) disability ben-
• Veterans with Disabilities Exemption
efits, proof includes a letter indicating SSI payments (COLA
• Homestead Exemption for Persons with Disabilities
Forms SSA-L8151, SSA-L8155, or SSA-L8156).
• Standard Homestead Exemption for Veterans with Disabilities
Proof of Veterans Administration disability benefits which
includes an award letter or verification letter indicating
Official use. Do not write in this space.
Board of review action date: ___ ___/___ ___/___ ___ ___ ___
Date received:___ ___/___ ___/___ ___ ___ ___
Approved
Denied
Verify Proof of Disability:
1
2
3
4
5
Reason for denial ________________________________________
Expiration date:___ ___/___ ___/___ ___ ___ ___
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
PTAX-343 (R-08/15)

Download Form PTAX-343 Application for the Homestead Exemption for Persons With Disabilities - St. Clair County, Michigan

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