Homestead Deduction And Senior Citizen Or Disabled Property Owner Application - District F Columbia Page 2
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4PART II – Senior Citizen or Disabled Property Owner Tax Relief
To apply for the Senior Citizen or Disabled Property Owner Tax Relief, you must: 1) answer all the questions in this Part II; 2) qualify the property to
receive the Homestead Deduction; 3) list the name(s) and social security number(s) of all wage earners living in the property; 4) complete PART I, PART II,
PART III and PART IV; and 5) file this application with the Office of Tax and Revenue.
1.
Are you 65 years or older? If YES, attach a copy of your driver’s license or District ID card.
Yes
No
2.
Are you deemed to be permanently and totally disabled by the Social Security
Administration (SSA) or do you receive disability payments?
Yes
No
If YES, attach a copy of the SSA certification or copies of federal, District or railroad disability payments.
3.
Do you own 50% or more of the property?
Yes
No
4.
Is the total adjusted gross income of everyone living in the house (excluding tenants under a
Yes
No
written lease) less than $100,000 for the prior calendar year?
5.
Provide your date of birth in the space provided:
(mmddyyyy)
List the name and social security number of each person living in the home other than you and tenants. If more than three
other people live in the home, attach a sheet of paper with the same information for them as required below.
First Name
Last Name
MI
Social Security Number
PART III – List of the residential properties you own in the District of Columbia
Please list the Square, Suffix, Lot and Premise Address of the properties which you own other than the one you have listed on the first page
them as shown below.
of this form. If you own more than five properties, attach a sheet of paper with the same information for
1.
Do you own other property in the District of Columbia?
Yes
No
If YES, how many ____________
Square
Suffix
Lot
Address
Check the appropriate box for the benefits you are
currently receiving
Homestead
Senior
Disabled
Tax
Abatement
Rev 7/09
Page 2 of 4
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