Form Tr-1040-X Amended Homestead Rebate Application (For Tenants Only) - 2007

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STATE OF NEW JERSEY
TR-1040-X
AMENDED
2007
HOMESTEAD REBATE APPLICATION
(FOR TENANTS ONLY)
Please Print or Type
You must enter your social security number below
Your Social Security Number
Last Name, First Name and Initial
(Joint filers enter first name and initial of each - Enter spouse/CU partner last name ONLY if different)
Home Address (Number and Street, including apartment number or rural route)
Spouse’s/CU Partner’s Social Security Number
County/Municipality Code
City, Town, Post Office
State
Zip Code
Reason for filing Form TR-1040-X (Check only one box)
To amend original tenant homestead rebate application (Form TR-1040). Complete Lines 1-16. (Do not use this form to file a 2007 tenant
homestead rebate application for the first time.)
To withdraw tenant homestead rebate application (Form TR-1040) that was filed in error. Provide explanation at Line 17.
NJ RESIDENCY STATUS
1.
Single
From________________________________
2.
Married/CU Couple, filing joint return
6. If you were a New Jersey resident for
Month
Day
Year
3.
Married/CU Partner, filing separate return
ONLY part of the taxable year, give the
4.
Head of household
period of New Jersey residency:
To___________________________________
5.
Qualifying widow(er)/Surviving CU Partner
Month
Day
Year
7. On October 1, 2007, I rented and occupied an apartment or other rental dwelling in New Jersey as my principal residence.
Yes
See instructions.
8. On December 31, 2007, I (and/or my spouse/CU partner) was a.
Age 65 or older
b.
Blind or disabled
c.
Not 65 or blind or disabled
Check only one box. See instructions.
9. Enter the GROSS INCOME you reported on Line 28, Form NJ-1040
or see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
10. If your filing status is MARRIED/CU PARTNER, FILING SEPARATE RETURN and you
and your spouse/CU partner MAINTAIN THE SAME PRINCIPAL RESIDENCE, enter
the gross income reported on your spouse’s/CU partner’s return
(Line 28, Form NJ-1040) and check this box
10
11. TOTAL GROSS INCOME (Add Line 9 and Line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
STOP - IF LINE 11 IS MORE THAN $100,000, YOU ARE NOT ELIGIBLE FOR A TENANT REBATE.
12. Enter the address of the rental property in New Jersey that was your principal residence on October 1, 2007.
Street Address (including apartment number) __________________________________________________ Municipality _____________________
13. Enter the total rent you (and your spouse/CU partner) paid during 2007 for the rental
property indicated at Line 12. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
14. Enter the number of days during 2007 that you (and your spouse/CU partner) occupied the rental
property indicated at Line 12. (If you lived there for all of 2007, enter 365) . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
days
15. Did anyone, other than your spouse/CU partner, occupy and share rent with you for the rental property indicated at Line 12?
Yes (If yes, you must complete Lines 15 a, b, and c)
No
15a. Enter the total number of tenants (including yourself) who shared the rent during the period
indicated at Line 14. (For this purpose, husband and wife/CU couple are considered one tenant). . . . . . . . . .
15a
tenants
15b. Enter the name(s) and social security number(s) of all other tenants (other than your spouse/CU partner) who shared the rent.
Name ________________________________________________________________________ SS# ____________/__________/____________
Name ________________________________________________________________________ SS# ____________/__________/____________
Name ________________________________________________________________________ SS# ____________/__________/____________
15c. Enter the total rent paid by all tenants during the period indicated at Line 14. . . . . . . . .
15c
Under the penalties of perjury, I declare that I have examined this rebate application, including accompanying documents, and to the
best of my knowledge and belief, it is true, correct, and complete and that I occupied the rental property for which I am applying for
the tenant homestead rebate as my principal residence on October 1, 2007. If prepared by a person other than taxpayer, this decla-
ration is based on all information of which the preparer has any knowledge.
±
Mail application to:
____________________________________________________________________________________________________________________
Your Signature
Date
±
NJ Division of Taxation
____________________________________________________________________________________________________________________
PO Box 253
Spouse’s/CU Partner’s Signature (if filing jointly, BOTH must sign)
Date
Paid Preparer’s Signature
Federal Identification Number
Trenton, NJ 08695-0253
Firm’s Name
Federal Employer Identification Number

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