FOR OFFICIAL USE ONLY
Form PD4
(rev. Nov. 2002)
BLOCK_______________ LOT______________
□ Claim by senior citizen
□ Claim by disabled person
□ Claim by surviving spouse of a senior citizen
□ Claim by surviving spouse of a disabled person
NOTICE OF DISALLOWANCE OF CLAIM FOR A REAL PROPERTY TAX DEDUCTION
ON DWELLING HOUSE OF A NEW JERSEY RESIDENT SENIOR CITIZEN,
DISABLED PERSON, OR SURVIVING SPOUSE
(N.J.S.A. 54:4-8.40 et seq.)
To:
This is to inform you that your application for the real property tax deduction upon your
dwelling house in this municipality for the tax year__________ has been disallowed for lack of:
(
) Age- 65 years or older
(
) Ownership of dwelling
(
) Occupancy of dwelling as principal or permanent residence
(
) Legal residence or domicile in New Jersey
(
) Annual income limit
(
) Permanent and total disability
(
) Qualification as surviving spouse of a deceased senior citizen or disabled person
property tax deduction recipient
(
) Other_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
An aggrieved taxpayer has the right to appeal the disallowance of a property tax deduction
to the county board of taxation, which will review all of the qualifications for the deduction. If
the municipal assessor or tax collector has disallowed the property tax deduction application
at a date too late to permit the filing of an appeal with the county board of taxation on or
before April 1 of the current year, then the claimant is entitled to file a petition of appeal at any
time on or before April 1 of the succeeding year. If you are considering an appeal, as soon as
possible please obtain information about the proper procedure to be followed and the time in
which to file the appeal from the _______________________ County Board of Taxation, at
________________________________ in ___________________________.
______________________________
_______________________
Assessor/Collector
Date