Form Ptr-1 - Property Tax Reimbursement Application - 2000

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PTR-1
STATE OF NEW JERSEY
2000 PROPERTY TAX REIMBURSEMENT APPLICATION
THIS IS NOT A HOMESTEAD REBATE APPLICATION
Your Social Security Number
Last Name, First Name and Initial
(Joint applicants enter first name and initial of each - Enter spouse last name ONLY if different)
Place
label on
form you
Spouse’s Social Security Number
Home Address (Number and Street, including apartment number or rural route)
file.
Make all
neces-
sary
changes
on label.
City, Town, Post Office
State
Zip Code
County/Municipality Code (See Table page 9)
1. RESIDENCY STATUS:
Homeowner
Mobile Home Owner
TO BE ELIGIBLE FOR THE REIMBURSEMENT YOU MUST:
A. Be age 65 or over OR receiving Federal Social Security disability benefits;
If you did not satisfy requirements A through D
B. Own a home OR lease a site in a mobile home park;
for both 1999 and 2000 you are not eligible for
C. Be domiciled in New Jersey for at least 10 consecutive years and have been a
the reimbursement and you should not file this
homeowner or tenant during that time;
application. If you satisfied requirements A
D. Have owned and lived in the home for which the reimbursement is being claimed
through D for both 1999 and 2000 you must
for at least 3 years;
now complete the worksheets on the back to
E. Have total annual income in 1999 of less than $18,151, if single or, if married, have
determine whether you also satisfy the income
total annual income combined with spouse less than $22,256.
requirements in E and F.
F. Have total annual income in 2000 of less than $18,587, if single or, if married, have
total annual income combined with spouse less than $22,791.
2. Enter the amount of 1999 Total Income from Worksheet A, Line p. (See reverse) . . . . . . . . . . . . . .
2.
,
.
3. 1999 Marital Status:
Single
Married
4. Did you meet all of the eligibility requirements as of December 31, 1999? If “Yes” check the box
and proceed to Worksheet B. If “No” you
are not eligible for the reimbursement and you should not file this application.
5.
5. Enter the amount of 2000 Total Income from Worksheet B, Line p. (See reverse)
. . . . . . . . . . . . . . . .
,
.
6. 2000 Marital Status:
Single
Married
7. Did you meet all of the eligibility requirements as of December 31, 2000? If “Yes” check the box
. If “No” you are not eligible for the
reimbursement and you should not file this application.
8. Enter the address for which you are claiming the reimbursement if different from above.
Street address ____________________________________________________________ Municipality ___________________________________
9. Homeowners: Enter the block and lot number of the residence for which the property tax reimbursement is being claimed.
Block
Lot
Qualifier
10. Enter your total 2000 property taxes due and paid on your principal residence.
10.
(Mobile Home Owners enter 18% of total 2000 site fee due and paid $___________________ x .18)
,
.
11. Enter your total 1999 property taxes due and paid on your principal residence.
11.
(Mobile Home Owners enter 18% of total 1999 site fee due and paid $___________________ x .18)
,
.
REIMBURSEMENT AMOUNT
12. Subtract Line 11 from Line 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12.
,
.
If Line 12 is less than or equal to zero you are not eligible for a property tax reimbursement and you should not file this application.
Division
1
2
3
4
5
6
Use
Under the penalties of perjury, I declare that I have examined this Property Tax Reimbursement Application, including accompanying
Due Date: March 15, 2001
schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. If prepared by a person other than
Mail your completed application to:
applicant, this declaration is based on all information of which the preparer has any knowledge.
NJ Division of Taxation
________________________________________________________ ______________________________________________________
Revenue Processing Center
Your Signature
Date
Spouse’s Signature (if applying jointly, BOTH must sign)
Property Tax Reimbursement
Paid Preparer’s Signature
Federal Identification Number
PO Box 635
Trenton, NJ 08646-0635
Firm’s Name
Federal Employer Identification Number
Tax Reimbursement Hotline:
1-800-882-6597

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