Form 104 Ptc - Colorado Property Tax/rent/heat Rebate Application - 2016 Page 3

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Page 3
Do you qualify for the PTC Rebate?
Step 1
Did you live in Colorado from January 1–December 31, 2016? If you visit family out of state, but return to your
Colorado home, you are still a Colorado resident. Yes. Continue to STEP 2. No.
You do not qualify for the PTC.
Step 2
Is your TOTAL income from all sources less than the amounts in the table below?
Single
$13,234
Married (combined income) $17,839
Yes. Continue to STEP 3. No.
You do not qualify for the PTC.
Step 3
As of December 31, 2016, did you meet one of the age criteria in the table below? If married, at least one person has
to meet the criteria.
Age 65 or older.
A surviving spouse, age 58 or older. If you were
divorced before your spouse died, you are not
considered a surviving spouse and must therefore
meet one of the other age criteria.
A disabled person of any age, who was unable to
engage in any substantial gainful activity for medical
reasons. You must also have been qualified for full
benefits from January 1–December 31, 2016 from
a bona fide public or private plan or source, based
solely on your disability.
Yes. Continue to STEP 4. No.
You do not qualify for the PTC.
Step 4
Were you lawfully present in the United States during this year? Applicants age 18 or older must have a valid Colorado
driver license or ID card, and must supply the number on their PTC application. See the last page of this booklet for more
information. Yes. Continue to STEP 5. No.
You do not qualify for the PTC.
Step 5
Did you pay property tax, rent or heating bills during this PTC period? Yes. Continue to STEP 6. No.
You do not
qualify for the PTC.
Step 6
Were you claimed as a dependant on some one else’s federal income tax return? Yes.
You do not qualify for the
PTC. No. You qualify. Continue to the application.
When will my rebate be issued?
The Colorado PTC rebate is paid on a set schedule based on when your application is processed. For faster delivery, we
recommend that you file in January or early February and that you sign up for Direct Deposit (see page 4). This payment
schedule is set by law and we cannot make any exceptions, except that any processing or payment dates that fall on the
weekend will instead happen on the next business day. Please review the application/payment chart below.
Application received,
Number
Direct Deposit
Paper Check Payment
Amount of Each
approved, and processed
of Equal
Payment Dates
Dates
Installment Payment
before
Installments
March 10, 2017
April 5, 2017
April 15, 2017
1/4 of total rebate
4
June 10, 2017
July 5, 2017
July 15, 2017
1/3 of total rebate
3
September 10, 2017
October 5, 2017
October 15, 2017
1/2 of total rebate
2
December 10, 2017
January 5, 2018
January 15, 2018
Full rebate
1
December 31, 2018
10 weeks after receipt
12 weeks after receipt
Full rebate
1
Do not call prior to these dates.
Example: Mary Jones mails her application on January 20, 2017 and she selects Direct Deposit. She will receive 4 equal
payments, one of each being deposited in her account by 4/5/17, 7/5/17, 10/5/17 and 1/5/18.
Deadline for filing your application
Applications for the Colorado PTC rebate for calendar year 2016 must be filed before December 31, 2018.
Applications received after that date will be denied.

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