REAL ESTATE TAX EXEMPTION PROGRAM
CHECKLIST
Documents Required
:
● Military Discharge (DD Form 214) showing wartime service
● Marriage Certificate (spouse application only)
● Veteran’s Death Certificate (spouse application only)
Required Income Verification Documentation must reflect Previous Calendar
)
- 2014
Year
● 1040 Federal Income Tax Return (If you are required to file.)
● VA Compensation Rating Letter (must include effective date)
● Monthly disability amount (Included on VA Award Letter or annual verification letter)
● Employment Income (most recent W-2 or pay stub)
● Social Security Benefit Statement (Form SSA-1099)
● Interest Income (Form 1099-INT)
● Dividend Income (Form 1099-DIV)
● Distribution from Pensions, Annuities, Retirement or Profit Sharing Plans, IRA’s,
Insurance Contracts, etc. (Form 1099-R)
Expense Documentation Required:
$87,212
If your annual income exceeds
record your monthly expenses and bring
supporting documentation at time of appointment.
*1. Mortgage Payment ___________
11. Domestic Help _____________
(Indicate below costs included in mortgage payment) *12. Educational Costs _____________
*13. Home Improvement(s) Over $200 ______
' Principal ' Interest ' Mortgage Ins. ' Taxes
2. Real Estate Tax ______________
*14. Major Purchases Over $200 (includes car
*3. Loan Payments ______________
bought for cash) ____________
______
*4. Car Payment ________________
*15. Medical Bills for Legal Dependents
5. Average Monthly Electric Power __________
*16. Car Repairs (over $100 not covered
6. Average Monthly Home Heating Fuel _________
by insurance) ____________
7. Water __________
*17. Lot Rental ______________
8. Sewage ___________
*18. Miscellaneous Bills
9. Trash Removal _________
(Auto, Homeowner’s, Health & Life
10. Telephone ____________
Insurance Premiums; Cable TV, Internet
_____
Service and Major Credit Cards)
***Application cannot be submitted without County Director’s signature***
CALL 717.771.9218 to set up appointment with VSO to complete the application
York County Veteran Affairs
100 West Market Street, Suite 100
York, PA 17401