Property Tax Relief Application Form - City Of Pittsburgh

Property Tax Relief Application Form - City Of Pittsburgh - 2010

CITY OF PITTSBURGH

ACT 77 -- PROPERTY TAX RELIEF APPLICATION FOR 2010

412 255-2525

This is a two-sided form. Complete both sides of this application.

Print the following information:

Property Owner Name:

Street Address:

City

State

Zip Code

Property Tax Account Number as it appears on your tax bill:

1) Property Address ________________________

Date purchased ____________

Is the property used as your principal residence?

Yes ( ) No ( )

How many years have you occupied the property? ________________

2) Does anyone beside you and your spouse own this house? Yes ( ) No ( )

Does this other owner live with you? Yes ( )

No ( )

Does Not Apply ( )

If No, what is their address?_____________________________________________

3) If not owned and occupied for at least 10 consecutive years, what property did

you OWN and OCCUPY in Allegheny County as your principal residence prior to

purchasing your current residence?

Address______________________________________

Date Purchased _________________

Ward or Municipality____________________________

Block & Lot_____________________

4) What is your date of birth?_______________________ (attach proof)

5) What is your spouse’s date of birth?________________ (attach proof)

Are you or your spouse permanently disabled and age 18 or older (you must

provide proof of disability). Yes (

)

No (

)

Check here if Spouse is Deceased ( )

Date of Death____________________

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rev 8/1/02

Property Tax Relief Application Form - City Of Pittsburgh - 2010