Property Tax Rebate Application For 2017-18 Taxes - Parkland School District printable pdf download

Property Tax Rebate Application For 2017-18 Taxes - Parkland School District

PARKLAND SCHOOL DISTRICT

PROPERTY TAX REBATE APPLICATION

FOR 2017-18 TAXES

Please Print or Type all information.

Deadline for filing is June 30, 2018

PART I – CLAIMANT INFORMATION:

Claimant’s Name

________________________________________________

Claimant’s Social Security Number

________________________________

Spouse’s Name

________________________________________________

Spouse’s Social Security Number

________________________________

Street Number, P.O. Box, etc:

________________________________

City, State & ZIP Code

___________________________________________

Claimant’s Date of Birth

_____________________________________

Spouse’s Date of Birth

_____________________________________

Daytime Telephone Number

_____________________________________

Municipality of Residence (Check one):

□

North Whitehall

South Whitehall

Upper Macungie

PART II – FILING STATUS:

I certify that I am: (check one box only):

□

A Claimant, age 65 or older as of December 31, 2017.

□

A Claimant under age 65 with a spouse age 65 or older as of December 31, 2017.

□

A Widow or Widower, age 50 to 64 as of December 31, 2017.

□

Permanently Disabled, age 18 to 64 during 2017.

PART III – SIGN & DATE:

CLAIMANT: I declare that this claim is true, correct and complete to the best of my knowledge

and belief, and this is the only claim filed by members of my household.

_______________________________________

_____________

Claimant’s Signature

Date

A SIGNED COPY OF FORM PA-1000, COMPLETE WITH ALL APPLICABLE SCHEDULES

AND A COPY OF YOUR RECEIPTED SCHOOL PROPERTY TAX BILL MUST BE

ATTACHED TO THIS FORM IN ORDER TO BE ELIGIBLE TO RECEIVE A PROPERTY TAX

REBATE.

See reverse side for directions

Property Tax Rebate Application For 2017-18 Taxes - Parkland School District

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