Form Ptr-1a - Homeowners Verification Of 2007 And 2008 Property Taxes
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1Form PTR-1A
Homeowners
Verification of 2007 and 2008 Property Taxes
(Use blue or black ink. See instructions for completion on back.)
Part I — To Be Completed by Applicant
(Part II to be completed by tax collector)
–
–
–
–
Social Security #
Spouse’s/CU Partner’s Social Security #
Name
Last Name, First Name, and Initial (Joint filers enter first name and initial of each Enter spouse’s/CU partner’s last name ONLY if different)
Address
Street
City
State
Zip Code
Block
Lot
Qualifier
2007
2008
A. Did you own your principal residence with someone who was not your spouse/CU partner?
Yes
No
Yes
No
%
%
B. If yes, indicate the share (percentage) of property that you (and your spouse/CU partner) owned.
C. Does your principal residence have more than one unit?
Yes
No
Yes
No
%
%
D. If yes, indicate the share (percentage) of property used as your principal residence.
Part II — To Be Completed by Tax Collector
2007 Property Taxes
2008 Property Taxes
1. Total Amount Levied by Municipality (before
1. Total Amount Levied by Municipality (before
Deductions and/or Credits are subtracted) ....... $ _________
Deductions and/or Credits are subtracted) ....... $ _________
2. Total 2007 Taxes Paid
2. Total 2008 Taxes Paid
by Homeowner(s) by 6/1/08 ...... $ _________
by Homeowner(s) by 6/1/09 ...... $ _________
3. Senior Citizen’s Deduction ........ $ _________
3. Senior Citizen’s Deduction ........ $ _________
4. Veteran’s Deduction .................. $ _________
4. Veteran’s Deduction .................. $ _________
5. REAP Credit .............................. $ _________
5. REAP Credit .............................. $ _________
6. Total Deductions and Credits
6. Total Deductions and Credits
(Add Lines 2, 3, 4, and 5) .................................. $ _________
(Add Lines 2, 3, 4, and 5) .................................. $ _________
If line 6 is equal to line 1, complete line 7
If line 6 is equal to line 1, complete line 7
7. Enter amount from Line 6. If applicant
7. Enter amount from Line 6. If applicant
answered “Yes” to Questions A and/or
answered “Yes” to Questions A and/or
C above, the amount on Line 7 must be
C above, the amount on Line 7 must be
apportioned. See instructions on back. ............. $ _________
apportioned. See instructions on back. ............. $ _________
Applicant enters this amount on line 14, Form PTR-1
Applicant enters this amount on line 13, Form PTR-1
I certify that I am the local tax collector of
, where the above property is
located. I further certify that the above‑stated amounts of property taxes due and paid for calendar years 2007 and 2008 are true and
accurate to the best of my knowledge. I have placed my stamp below for verification.
(Name)
(Title)
(If you complete this form, be sure to enclose it with your Form PTR-1 application.)
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