Form Hpc - Application For Homestead Preservation Credit

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APPLICATION MUST BE
MISSOURI DEPARTMENT OF REVENUE
HPC
FORM
POSTMARKED BETWEEN
TAXATION BUREAU
2008 APPLICATION FOR HOMESTEAD
APRIL 1 AND
PRESERVATION CREDIT
(REV. 2-2008)
OCTOBER 15, 2008.
LAST NAME
FIRST NAME
MIDDLE INITIAL
DECEASED IN 2008
BIRTHDATE (MM/DD/YY)
AGE
SOCIAL SECURITY NUMBER
__ __ / __ __ / __ __
__ __ __ - __ __ - __ __ __ __
SPOUSE’S OR JOINT OWNER’S LAST NAME
FIRST NAME
MIDDLE INITIAL
DECEASED IN 2008
BIRTHDATE (MM/DD/YY)
AGE
SOCIAL SECURITY NUMBER
__ __ / __ __ / __ __
__ __ __ - __ __ - __ __ __ __
COUNTY OF HOMESTEAD PROPERTY
TELEPHONE NUMBER
(__ __ __ ) __ __ __ - __ __ __ __
MAILING ADDRESS
CITY, STATE, ZIP CODE
QUALIFICATIONS (Check the appropriate box.)
A. 65 years of age or older (if married, spouse is at least 60 years of age or older) as of January 1, 2008
B. 100% Disabled Veteran as a result of military service (Attach a copy of the letter from Department of Veterans Affairs.)
C. 100% Disabled (Attach a copy of the letter from Social Security Administration or Form SSA-1099.)
If claiming credit eligibility due to being disabled, verification of disability is required. Attach a copy of approved forms of documentation
(see instructions). FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN CREDIT BEING DENIED.
00
1. a. FEDERAL ADJUSTED GROSS INCOME AS SHOWN ON YOUR 2007 FEDERAL INDIVIDUAL INCOME TAX RETURN ROUNDED TO THE
$
NEAREST WHOLE DOLLAR (See instructions and chart.) (You do not have to attach a copy
of your federal return if you filed a 2007 Missouri Individual Income Tax Return.)
b. Are you required to file a Federal Return?
YES
NO
(MUST BE $77,323 OR BELOW)
2. ENTER THE ADDRESS OF HOMESTEAD PROPERTY (primary residence owned and occupied) FOR WHICH APPLICATION IS FILED:
STREET ADDRESS
CITY, STATE, ZIP
3. ENTER THE PARCEL NUMBER (IN SOME COUNTIES THIS MAY BE THE LOCATOR OR ACCOUNT NUMBER) FROM YOUR PAID REAL
ESTATE TAX RECEIPT AND/OR FROM YOUR COUNTY COLLECTOR’S OFFICE:
_________________________________________________________________________________________________________________
4. a. DID YOU MAKE IMPROVEMENTS TO THE HOMESTEAD IN 2006?
YES
NO
b. Were the improvements made to accommodate a disabled individual?
YES
NO
5. a. ENTER TOTAL ACRES OF HOMESTEAD PROPERTY ____________ .
b. Is the homestead property more than five acres?
YES
NO
c. Is your homestead a mobile home?
YES
NO
d. If you own a mobile home or your home is on more than five acres, is Form 948, Assessor’s Certification attached?
YES
NO
6. a. ENTER THE 2006 REAL ESTATE TAXES PAID (INCLUDING HPC CREDITS PAID BY
$
THE STATE, IF ANY). IF HOMESTEAD PROPERTY IS A MOBILE HOME, ENTER THE
AMOUNT FIGURED ON FORM 948.
6a.
b. ENTER THE 2007 REAL ESTATE TAXES PAID (INCLUDING HPC CREDITS PAID
Line 6b must be at least 5% greater than line 6a.
$
BY THE STATE, IF ANY). IF HOMESTEAD PROPERTY IS A MOBILE HOME, ENTER
THE AMOUNT FIGURED ON FORM 948.
6b.
Attach copies of PAID real estate property tax receipts for 2005, 2006, and 2007 and/or PAID personal property tax receipts if homestead property is a mobile
home for the tax years 2005, 2006, and 2007. (Mortgage statement will not be accepted.) To obtain copies of your paid real estate property tax receipts
and/or paid personal property tax receipts (for your mobile home), you can contact your County Collector’s Office. Do not include special assessments (sewer
lateral), penalties, service charges, or interest listed on your tax receipt.
Under penalties of perjury, I declare that I have examined this application, including accompanying attachments and to the best of my knowledge and belief it is true, correct, and
complete. I also declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or
abatement if I employ such aliens.
SIGNATURE
DATE
SPOUSE’S SIGNATURE
DATE
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
Mail your application and all required attachments to:
Department of Revenue, P.O. Box 478, Jefferson City, MO 65105-0478.
This publication is available upon request in alternative accessible format(s).
MO 860-3035 (2-2008)

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