Form 90r - Oregon Elderly Rental Assistance Program - 2011

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2011 Elderly Rental Assistance Program
Form 90R and Instructions
Elderly Rental Assistance (ERA) is for low-income
Where do I send Form 90R?
people age 58 or older who rent their home. ERA
is based on your income, assets, and the amount of
PO Box 14700
rent, fuel, and utilities you paid. The property you
Salem OR 97309‑0930
rent must be subject to property tax. If the property
When will I get my assistance check?
you rent is exempt from property tax you are not
wner makes
eligible for ERA unless the property o
If you file Form 90R by July 1, 2012, your ERA check
a “payment in lieu of tax” (PILOT). You must
will be mailed to you in November. If your Form
file a Form 90R to receive ERA.
90R is filed after July 1, your check can’t be issued
until November 2013.
You qualify for ERA if all the following are true:
• You or your spouse/registered domestic partner
Fraudulent claims
(RDP) were age 58 or older on December 31, 2011;
Filing a fraudulent Form 90R is against the law. You
could be charged with a class C felony. You could
• You and your spouse’s/RDP’s household income
be fined up to $100,000 and serve a jail sentence.
was under $10,000; and
You would also be required to pay back twice the
• You paid more than 20 percent of your household
amount you received plus interest.
income for rent, fuel, and utilities (see “Special
Special instructions
instructions” on this page); and
• The total value of you and your spouse’s/RDP’s
Single. If you were single on December 31, 2011, list
household assets is $25,000 or less (if you or your
only the rent, fuel, and utilities you actually paid.
spouse/RDP are age 65 or older on December 31,
Do not list any amounts paid by anyone else.
there is no limit on the value of household assets);
Roommates. Each roommate can file for ERA. The
amount of assistance is based on the rent, fuel, utili-
• You rented an Oregon residence that was subject
ties, household income, and assets of each person.
to property tax or PILOT; and
List the names of all renters and the rent, fuel, and
• You lived in Oregon on December 31; and
utilities you alone paid.
• You didn’t own your residence on December 31
Recently married/registered. Did you marry or
(if you live in a manufactured home, see page 2).
register your domestic partnership during 2011? If
so, you must file jointly. Include the rent, fuel, and
Household income includes all taxable and nontax-
utilities paid both separately and together.
able income. See page 2.
Married/RDP—living together. If you were mar-
Fuel and utilities include the amount you paid in
ried/RDP and living together on December 31, 2011,
2011 for lights, water, garbage, sewer, and heating.
you must file jointly. The assistance is based on the
Do not include food expenses or payments for tele-
rent, fuel, utilities, household income, and assets
phone, cable tv, or internet access.
of both people.
Household assets include real and personal prop-
Married/RDP—living apart. If you were married/
erty described on page 3. See the list on Form 90R.
RDP and permanently living apart on December
31, you may file separately. List only the rent, fuel,
When do I file Form 90R?
and utilities you paid. File jointly if you are only
temporarily living apart.
Claim Year
File By
Accepted Until
Deceased persons. You cannot file a Form 90R for
July 1, 2012
July 1, 2015
a deceased person.
150-545-002 (Rev. 12-11)


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