Form Av-9 - Application For Property Tax Relief - 2017 Page 2

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Page 2,
AV-9, Web, 7-16
Part 1. Selecting the Program
Each owner may receive benefit from only one of the three property tax relief programs, even though you may meet the
requirements for more than one program.
However, it is possible that the tax rates or tax values may not be established until some time after the filing of this application. This
can make it difficult for you to determine which program you prefer. The following procedures will help to resolve this situation.
Applying for One Program
If you know that you only wish to apply for one program, indicate only that program at the bottom of this section. The assessor will
review your application and send you a notice of decision. The notice of decision will also explain the procedures to appeal if you do
not agree with the decision of the assessor.
Applying for More Than One Program
Each owner is eligible to receive benefit from only one program. However, if you think you meet the requirements for more than
one program but, as a result of the uncertainty of tax rates or values at the time of application, you are unable to make a decision
on which one program you wish to choose, indicate all of the programs at the bottom of this section for which you wish to receive
consideration. When the tax rates and values are determined, the assessor will review your application and will send you a letter
notifying you of your options. If the letter indicates that you do not qualify or if you disagree with any decision in the letter, you may
appeal. You must respond to the option letter within the specified time period or it will be assumed that you do not wish
to participate in any of the property tax relief programs. In that case, you will be so notified and you will have the chance to
appeal.
Please read the descriptions and requirements of the three programs on the following pages and
then select the program(s) for which you are applying:
Fill in applicable circles:
You Must Complete:
Elderly or Disabled Exclusion
Parts 2, 5, 6
Disabled Veteran Exclusion
Parts 3, 6
Circuit Breaker Tax Deferment Program
Parts 4, 5, 6
If you select more than one program, please read ALL of the information on this page!
Part 2. Elderly or Disabled Exclusion
Short Description: This program excludes the greater of the first $25,000 or 50% of the appraised value of the permanent residence
of a qualifying owner. A qualifying owner must either be at least 65 years of age or be totally and permanently disabled. The owner
cannot have an income amount for the previous year that exceeds the income eligibility limit for the current year, which for the 2017
tax year is $29,500. See G.S. 105-277.1 for the full text of the statute.
Multiple Owners: Benefit limitations may apply when there are multiple owners. Each owner must file a separate application (other
than husband and wife). Each eligible owner may receive benefits under either the Elderly or Disabled Exclusion or the Disabled
Veteran Exclusion. The Circuit Breaker Property Tax Deferment cannot be combined with either of these two programs.
Fill in applicable boxes:
As of January 1, were either you or your spouse (if applicable) at least 65 years of age? If you answer Yes, you do
Yes
No
not have to file Form AV-9A Certification of Disability.
As of January 1, were you and your spouse (if applicable) both less than 65 years of age and at least one of you
Yes
No
was totally and permanently disabled? If you answer Yes, you must file Form AV-9A Certification of Disability.
Requirements:
1. File Form AV-9A Certification of Disability if required above.
2. Complete Part 5. Income Information.
3. Complete Part 6. Affirmation and Signature.

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