Schedule H - Homeowner And Renter Property Tax Credit - 2012 Page 2
Download a blank fillable Schedule H - Homeowner And Renter Property Tax Credit - 2012 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Schedule H - Homeowner And Renter Property Tax Credit - 2012 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3l
*129980120002*
2012 SCHEDULE H PAGE 2
Last name and SSN
If you are blind or disabled, you must have this certificate completed to claim the Property Tax Credit. File it with your Schedule H.
Physician’s certification of blindness or disability.
If a physician’s certification of blindness or disability has been submitted previously and the claimant’s condition is unchanged, additional certifications
are not needed.
Claimant’s first name
M.I.
Last name
Claimant’s social security number
I certify that the above-named claimant
(fill in all that apply):
is blind;
has a physical or mental impairment that is expected to last continuously for 12 months or more;
was physically or mentally impaired on January 1, 2012.
Physician’s first name
M.I.
Last name
Physician’s address (number and street)
Suite number
City
State
Zip Code +4
Physician’s signature
Date
Where Licensed
License Number
Definitions
Blind
Central visual acuity that does not exceed 20/200 in the better eye
with correcting lenses, or visual acuity that is greater than 20/200,
but is accompanied by a limitation in the field of vision such that
the widest diameter of the visual field subtends an angle no greater
than 20 degrees.
Disabled
Unable to engage in any gainful activity due to a medically determin-
able physical or mental impairment which can be expected to last
for 12 months or more.
Signature
Under penalties of law, I declare that I have examined this return and, to the best of my knowledge, it is true and correct.
Declaration of paid preparer is based on the information available to the preparer.
Your signature
Date
Paid preparer’s signature
Date
Paid preparer’s PTIN
Paid preparer’s telephone number
l
2012 SCHEDULE H P2
l
Homeowner and Renter Property Tax Credit
File order 6
Revised 11/12
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial