Form Ptax-324 - Application For Senior Citizens Homestead Exemption

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PTAX-324
Application for Senior Citizens Homestead Exemption
Step 1: Complete the following information
1
4
___________________________________________________
Enter the assessment year for which you are requesting
Property owner’s name
___ ___ ___ ___
the senior citizens homestead exemption.
Year
___________________________________________________
Street address of homestead property
5
Enter the property index number (PIN) of the property for which
IL
___________________________________________________
you are requesting the senior citizens homestead exemption.
City
State
ZIP
Your PIN is listed on your property tax bill or you may obtain it
(_______)______________ ____________________________
from the chief county assessment officer (CCAO). If you are
Daytime phone
Email address
unable to obtain your PIN, enter the legal description on Line b.
Send notice to (if different than above)
a
PIN ________________________________________
2
___________________________________________________
Name
b
Enter the legal description only if you are unable to
___________________________________________________
obtain your PIN. (Attach separate sheet if needed.)
Mailing address
_________________________________________________
___________________________________________________
_________________________________________________
City
State
ZIP
_________________________________________________
(_______)______________ ____________________________
_________________________________________________
Daytime phone
Email address
3
______/______/____________
6
Enter your date of birth.
Have you previously received a senior citizens
Month
Day
Year
homestead exemption on this property?
Yes
No
*Proof of age required. See General Information.
Step 2: Complete eligibility information
7
9
Check your type of residence.
On January 1 did you occupy this property
Single-family dwelling
Duplex
as your principal residence?
Yes
No
Townhome
Condominium
If No, enter the date you first occupied this
______/______/____________
Apartment
Other __________________
property. (if applicable)
Month
Day
Year
a
Is the residence operated as
10
On January 1 were you a resident of a facility licensed under the
a cooperative?
Yes
No
Assisted Living & Shared Housing Act, Nursing Home Care Act,
b
Is the residence a life care facility under
ID/DD Community Care Act, MC/DD Act or Specialized Mental
the Life Care Facilities Act?
Yes
No
Health Rehabilitation Act of 2013?
Yes
No
If Yes,
8
On January 1 were you the owner of record or
a
enter the name and address of the facility.
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
b
was this property occupied by your
If No, enter the date you acquired an interest
spouse, who is 65 years of age or older?
Yes
No
______/______/____________
in this property.
______/______/____________
If “Yes”, spouse’s date of birth
Month
Day
Year
Month
Day
Year
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
Step 3: Attach proof of ownership
12
13
Check the type of documentation you are attaching as proof that
Enter the date the written
______/______/____________
you are the owner of record or have a legal or equitable interest
instrument was executed.
Month
Day
Year
in the property.
14
If known, enter the date recorded and the document number.
Deed
Contract for deed
Trust agreement
Life care contract
______/______/____________
_________________
Lease
Other written instrument
Month
Day
Year
Document number
(specify)___________________
____________
Step 4: Sign below
I state that to the best of my knowledge, the information on this application is true, correct, and complete.
______/______/____________
____________________________________________________
Month
Day
Year
Property owner’s or authorized representative’s signature
PTAX-324 Front (R-06/16)

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