Form Ptax-342-R - Annual Verification Of Eligibility For Disabled Veterans' Standard Homestead Exemption
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To continue to receive Disabled Veterans’ Standard Homestead Exemption (DVSHE), you must file Form PTAX-342-R each year with
your Chief County Assessment Officer (CCAO). Failure to do so may result in the termination of the exemption. Your service-connected
disability must be certified by the U.S. Department of Veterans’ Affairs.
Note: Only an un-remarried, surviving spouse of a disabled veteran can continue to receive the DVSHE provided the spouse has legal
or beneficial title to the property. A surviving spouse that remarries no longer qualifies for the DVSHE.
/DVW GDWH WR DSSO\ ___ ___/___ ___/___ ___ ___ ___
Step 1:
Complete the following information
1
_________________________________________________
3
Assessment year for which
Property owner’s name
___ ___ ___ ___
you are requesting the DVSHE:
Year
_________________________________________________
Street address of homestead property
4
Did you receive the DVSHE for the prior
IL
assessment year on this property?
Yes
No
_________________________________________________
City
State
ZIP
If “Yes,”
check the amount of the DVSHE.
___ ___ ___
___ ___ ___ - ___ ___ ___ ___
(
)
$2,500 EAV reduction
$5,000 EAV reduction
Daytime phone
5
Write the property index number (PIN) of the property for which
you receive the exemption listed on your property tax bill. You
2
Check one statement that applies.
may obtain it from your CCAO. If you are unable to obtain your
PIN, write the legal description on Line b.
a _______ Disabled veteran that currently has a 50% to 69%
service-connected disability.
PIN __________________________________________
a
b _______ Disabled veteran that currently has at least a 70%
b Write the legal description only if you are unable to obtain
service-connected disability. If this is an increase
your PIN. Attach a separate sheet if needed.
from the prior year, you must submit documentation
verifying the increase.
______________________________________________
c _______ Un-remarried, surviving spouse of a disabled
______________________________________________
veteran.
______________________________________________
Step 2:
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6
Is this the only property for which you have applied for a homestead exemption?
Yes
No
7
On January 1, were you the owner of the property?
Yes
No
If “No,” on January 1 did you lease the property?
Yes
No
8
On January 1, did you occupy this property as your principal residence?
Yes
No
If “No,” complete Lines a and b.
a Were you a resident of a facility licensed under the Nursing Home Care Act?
Yes
No
b Was this property occupied by your spouse or did it remain unoccupied?
Yes
No
9
On January 1, were you a resident of a facility licensed under the Nursing
Home Care Act or operated by the U.S. Department of Veterans’ Affairs?
Yes
No
If “Yes,” complete Lines a through c.
a Write the name and address of the facility.
_________________________________________________
_________________________________________________
b Was your property occupied by your spouse?
Yes
No
c Did your property remain unoccupied?
Yes
No
10
Are you liable for the payment of real estate taxes?
Yes
No
Step 3:
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I state that to the best of my knowledge, the information contained in this application is true, correct, and complete.
____________________________________________________
___ ___/___ ___/___ ___ ___ ___
Property owner’s or authorized representative’s signature
Date
PTAX-342-R (R-1/13)
IL-492-4535
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