Instructions And Benefits Information For Form Il-1363 - Illinois Department Of Revenue - 2002 Page 2

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Who should apply?
Apply for benefits if you meet the following
3 Income
requirements for age, residency, and income:
Your* total income (see Page 12) in 2002** must
be less than
1 Age
$21,218 if filing an application for yourself only;
you must be 65 years of age or older before
or
January 1, 2003; or
$28,480 if filing an application for yourself and
you must become 65 years of age during 2003
your spouse*, or yourself and one qualified
(see “What if I become 65 years old in 2003?”
additional resident; or
on page 3); or
$35,740 if filing an application for yourself, your
you must be 16 years of age or older before
spouse*, and at least one qualified additional
January 1, 2003, and totally disabled; or
resident, or yourself and at least two qualified
you must be a widow or widower who was 63
additional residents.
or 64 years of age before the death of your
spouse (if your spouse was receiving or was
eligible to receive program benefits).
* If your spouse lives with you, you must add
your spouse’s income to your income.
2 Residency
** If your 2002 income was over these limits, but
you must live in Illinois at the time you file your
you have experienced a decrease in your income,
application; and
you may qualify for prescription coverage. See
(this requirement is only for a grant) you
“Projecting your income” in the instructions for
must have lived in an llinois residence in 2002
Step 4 on Page 14.
that was subject to property or mobile home
tax.
When must I apply?
Send us your completed Form IL-1363, Application
Get your benefits quickly!
for Circuit Breaker and Prescription Coverage, as
We can process applications filed over the
soon as you have the necessary information if you
Internet faster than those we receive in the
want prescription coverage. All prescription coverage
mail.
we issue in 2003 will end June 30, 2004.
You may file your Form IL-1363 on the
Your 2002 Form IL-1363 must be postmarked on or
Internet, if
before December 31, 2003.
you filed Form IL-1363 last year and were approved;
your marital status did not change; and
you are not required to file
Schedules A, B, or P.
How do I apply for benefits?
If you send us your completed Form IL-1363, you
spouse is 65 years old or older or will become
have applied for a Circuit Breaker grant and a
65 years of age during 2003, make sure you
license plate discount.You do not have to receive a
also complete Line 12b or 12c.
grant to qualify for other benefits.
your qualified additional resident, make sure
you check the correct box on Schedule B.
If you want to apply for prescription coverage for
yourself, complete Form IL-1363 and make sure
If you want the SeniorCare rebate, you must
you check the box on Line 5a. If you are 65
complete the following two steps.
years old or older or will become 65 years of
First, to apply for the rebate for
age during 2003, make sure you also complete
yourself, check the box on Line 5a and complete
Line 5b or 5c.
Line 5b or 5c on Form IL-1363.
your spouse, complete Form IL-1363 and make
your spouse, check the box on Line 12a and
sure you check the box on Line 12a. If your
complete Line 12b or 12c on Form IL-1363.
2
Avoid a delay
Apply by March 31
IL-1363 instructions (R-12/02)

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