Form Tc-40cy - Low Income Abatement And Homeowner'S Tax Credit Application - 2015
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County Application
Low Income Abatement and
TC-40CY
2015
Homeowner's Tax Credit Application
Rev. 4/15
(For low income, elderly, and widows/widowers)
Homeowners and Mobile Homeowners applying for property tax credit must file this form with the county where the home is
located by September 1, 2015.
Renters and Mobile Homeowners applying for lot rental refund, file the TC-40CB application with the Utah State Tax
Commission by December 31, 2015.
Applicants who check box 2 in Section 5 (back of form) must file this form in person.
Section 1 - Applicant's Name If more than one person lives in a household, only one person may file an application.
Applicant's Last Name
Applicant's First Name
Middle Initial
Birth Date
Social Security Number
Spouse's Last Name (if spouse is living)
Spouse's First Name
Middle Initial
Birth Date
Social Security Number
Address
City
County
State
ZIP Code
Daytime Telephone Number
Enter your property serial/account number(s)
from your most recent property tax billing notice
Section 2 - Household Income Household income must include ALL household members' incomes.
Complete and add lines 1 through 10 and enter the total on line 11. Household income is income received during 2014 from all members
living in the household as of January 1, 2015, not just the applicant. A “household” is an association of all people living in the same
dwelling, sharing furnishings, facilities, accommodations and expenses. Send supporting income documentation for information
provided below.
Total members in household as of January 1, 2015
6. Government assistance
6
1. Wages/salaries/tips/other compensation
1
7. Unemployment, worker’s compensation
(W-2, 1099Misc, etc.)
7
8. Business, rental, farm income
8
2. Total interest income, dividends
2
(Include copy of federal return and all
(taxable/nontaxable)
schedules. This amount will be reviewed.)
3. Pensions, annuities-include IRAs
3
9. Depreciation on claimed residence
9
(taxable/nontaxable)(Include a copy of federal
(Include copy of federal return and all
return and all schedules. This amount will be reviewed.)
schedules. This amount will be reviewed.)
10
4. Social Security/Railroad retirement
10. Other income received under Utah Code
4
(taxable/nontaxable) (send supporting
Section 59-2-1202 such as alimony, nontaxable
documentation)
interest, etc. (send supporting documentation)
11. Total 2014 household income from
11
5. Current year capital gain or loss
5
all sources (add lines 1 through 10)
(Include copy of federal return and all
schedules. This amount will be reviewed.)
You do not qualify if the verified amount on line 11 exceeds $31,702. The
Tax Commission will review and determine eligibility for refund. You
may be required to submit additional information to support your claims.
Section 3 - Low Income Abatement To qualify for low income abatement, applicant must answer all three questions below.
1. Will you be age 65 or older on or before December 31, 2015, or under age 65 and disabled, or under age 65
Yes
No
and it would be an extreme hardship to pay the tax? If you are disabled and applying for the first time, attach a
medical statement signed by your doctor. If you are under extreme hardship, attach an explanation of hardship.
2. Was the total household income (from Section 2, line 11) less than $31,702?
Yes
No
3. Will you reside in the home for which you are claiming the abatement for ten months during 2015?
Yes
No
If the answer to all three questions is "Yes," you qualify for the low income abatement.
If you qualify for the low income abatement, you may also qualify for the homeowner's tax credit on the back of this form.
For more information, contact your county government listed below
Beaver County
435-438-6463
Garfield County
435-676-1109
Rich County
435-793-5155
Utah County
801-851-8110
Box Elder County
435-734-3388
Grand County
435-259-1338
Salt Lake County
385-468-8300
Wasatch County
435-654-3190
Cache County
435-755-1500
Iron County
435-477-8332
San Juan County
435-587-3223
Washington County 435-634-5712
Carbon County
435-636-3221
Juab County
435-623-3410
Sanpete County
435-835-2142
Wayne County
435-836-1300
Daggett County
435-784-3210
Kane County
435-644-2458
Sevier County
435-893-0400
Weber County
801-399-8400
Davis County
801-451-3367
Millard County
435-743-5227
Summit County
435-336-3254
Duchesne County
435-738-1120
Morgan County
801-845-4030
Tooele County
435-843-3130
Emery County
435-381-5106
Piute County
435-577-2840
Uintah County
435-781-5363
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