Form Hac - Application For The Home Accessibility Features For The Disabled Tax Credit - Virginia Department Of Taxation

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Form HAC
Virginia Department of Taxation
Tax Year
Application for the Home Accessibility
20
Features for the Disabled Tax Credit
Name
Social Security Number
Street Address
City
State
Zip Code
Submit this application as soon as possible after handicap accessibility work has been completed but no later than
March 15th of the year after such work is completed.
The Home Accessibility Features for the Disabled Tax Credit is the lesser of 25% of the amount spent on such features
(not to exceed $500) or the individual’s tax liability in the taxable year the work is completed. Tax credits authorized by the
Department of Taxation cannot exceed $1 million in any taxable year. If eligible credits exceed $1 million, all credits will be
prorated. See back for additional instructions.
Please attach documentation (such as receipts, copy of construction contract, etc.) to support your claim.
Address of Property (If Different From Above)
Date Work Completed
Please check the box below to identify the accessibility feature installed:
One No-step Entrance Allowing Access Into the Residence
Interior Passage Doors Providing a Thirty-Two-Inch Wide Clear Opening
Reinforcements in the Bathroom Walls and Installation of Grab Bars Around the Toilet, Tub, and Shower
Light Switches and Outlets Placed in Wheelchair-Accessible Locations
Universal Design Features or Those Accessibility or Adaptability Features Prescribed in the Virginia Uniform Statewide
Building Code (USBC) (Please Describe Feature(s).)
1. Total Cost of Qualifying Accessibility Feature(s) Added to Residence During the Taxable Year
1.
2. Enter 25% of Line 1
2.
500.00
3. Credit Limitation
3.
4. Enter the Smaller of Line 2 or Line 3 (This credit amount must be approved by the
department of taxation before being claimed on your return.)
4.
I declare, under penalties provided by law, the information provided above is complete and correct.
Signature
Official Use
Printed Name
Approved Credit
Date
Date
Phone Number
Certificate Number
Va. Dept. of Taxation
HAC W
REV 12/06

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