Form Ptax-342 - Application For Disabled Veterans' Standard Homestead Exemption (Dvshe)
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2PTAX-342
Application for Disabled Veterans’ Standard Homestead Exemption (DVSHE)
Step 1: Complete the following information
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6
________________________________________________
Write the property index number (PIN) of the property for which
Property owner’s name
you are requesting the DVSHE. Your PIN is listed on your
________________________________________________
property tax bill or you may obtain it from the Chief County
Street address of homestead property
Assessment Officer (CCAO).
IL
________________________________________________
City
State
ZIP
a
___________________________________________
PIN
(_______)_______-____________
b
Write the legal description only if you are unable to obtain
Daytime phone
your PIN. (Attach a separate sheet if needed.)
Send notice to (if different than above)
______________________________________________
2
______________________________________________
________________________________________________
Name
________________________________________________
7
On January 1, did you occupy this property
Mailing address
as your principal residence?
Yes
No
________________________________________________
City
State
ZIP
8
On January 1, was any portion of the property used
(_______)_______-____________
for commercial purposes or rented to another
Daytime phone
person or entity for more than 6 months?
Yes
No
3
Write the assessment year for
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On January 1, were you a resident of a facility
___ ___ ___ ___
which you are filing this form.
licensed under the Nursing Home Care Act
Year
4
On January 1, were you liable for the
or operated by the U.S. Department of
Veterans’ Affairs?
payment of real estate taxes on this property?
Yes
No
Yes
No
If “Yes,” complete Lines a through c.
5
Check your type of residence.
a
Write the name and address of the facility.
Single-family dwelling
Duplex
______________________________________________
Townhouse
Condominium
______________________________________________
Other ___________________________________________
b
Was your property occupied by your spouse?
Yes
No
c
Did your property remain unoccupied?
Yes
No
Step 2: Complete the disabled veterans’ eligibility information
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10
Are you a veteran or the un-remarried surviving spouse of a
Are you an Illinois resident?
Yes
No
veteran with a service-connected disability as certified
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Are you a veteran or the un-remarried surviving spouse of a
by the U.S. Department of Veterans’ Affairs?
Yes
No
disabled veteran who served as a member of the U.S. Armed
Forces on active duty or state active duty, Illinois National
Note: You must provide documentation. See “Do I need to
Guard, or U.S. Reserve Forces?
Yes
No
provide documentation?” on the back of this form.
Step 3: Complete the following information
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If you are the surviving spouse,
If you are the surviving spouse, a
re
you claiming this exemption on your
were you remarried as of January 1?
Yes
No
new primary residence for the first time?
Yes
No
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If you are claiming the DVSHE on this property for the first
If “Yes,” complete Lines a through c.
time, check the type of documentation you are attaching as
a
________________________________________________
proof that you have a legal or beneficial title to the property.
Deceased disabled veteran’s name
Date of death
Deed
Contract for deed
b
Did you sell your spouse’s homestead
Trust agreement
Other written instrument
property that received the DVSHE?
Yes
No
Lease
Specify:____________________
c
Identify the disabled veteran’s homestead property. You can
a
Write the date the written instrument
obtain this information from the property tax bill or CCAO.
___ ___/___ ___/___ ___ ___ ___
was executed.
______________________________________________
Month
Day
Year
Property owner’s name
b
If the instrument is recorded, complete the information below.
______________________________________________
Street address of homestead property
_______________________________________________________________
IL
______________________________________________
Recorded document number
City
State
ZIP
___ ___/___ ___/___ ___ ___ ___
Date document recorded
PIN __ __ - __ __ - __ __ __ - __ __ __ - __ __ __ __
Month
Day
Year
If needed, attach a legal description of the property.
Step 4: Sign below
I state that to the best of my knowledge, the information on this application is true, correct, and complete.
____________________________________________________
___ ___/___ ___/___ ___ ___ ___
Property owner’s or authorized representative’s signature
Month
Day
Year
PTAX-342 (R-1/13)
IL-492-4535
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