Form Tc-40cy - Indigent Abatement And Property Tax Credits Applications - Utah Department Of Revenue, 1998
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1
2County Application
TC-40CY
1998
Indigent Abatement and Property Tax Credits Application
Rev. 4/98
(For low income, elderly, and widows/widowers)
For assistance, refer to the county government telephone numbers listed below.
Homeowners
Check with your county for the property tax credit filing deadline (see listings below). If you miss your county filing
deadline, file your application for a property tax credit through the Utah State Tax Commission by December 31, 1998. Obtain the
Property Tax Refund Application form (TC-40CB) from your county government.
Renters and mobile homeowners
must file the Utah State Tax Commission Property Tax Refund Application for a refund.
Contact your county (see listings below) to obtain the Tax Commission Property Tax Refund Application form (TC-40CB).
Section 1 - Claimant's Name
If more than one person lives in a houshold, only one person can file an application.
Claimant's Last Name
Claimant's First Name
Middle Initial
Birth Date
Social Security Number
Spouse's Last Name (if spouse is living)
Spouse's First Name
Middle Initial
Birth Date
Social Security Number
Address
City
County
State
ZIP Code
Daytime Telephone Number
Enter your property serial/account number(s)
(from your prior property tax billing notice)
Section 2 - Household Income
Household income must include
ALL
household members' incomes.
Complete lines A through H. Total lines A through H, and enter the total on line I.
Household Income
: Household income is income received during 1997 by all members of a household, not just the applicant. A
"household" is an association of all people living in the same dwelling, sharing furnishings, facilities, accomodations and expenses.
Taxable Income
Non-taxable Income
A. Wages/salaries
A
E. Social Security/other government programs
E
B. Pensions/annuities
B
F. Capital gains/pensions/annuities
F
C. Interest/dividends/trusts
C
G. Interest/dividends/trust income
G
D. Alimony/other income
D
H. Loss carryforwards/rental depreciation
H
I. Total 1997 household income
from all sources
I
(add lines A through H)
Total members in household
Note:
You
do not
qualify if Line I exceeds $21,644.
Section 3 - Low Income Credit
To qualify for low income credit, you must answer all three questions below.
Yes
No
1.
Will you be age 65 or older before December 31, 1998?
or
Under age 65, disabled, widow or widower?
or
Under extreme hardship? If you are disabled and applying for the first time, attach a medical
statement signed by your doctor. If you are under extreme hardship, attach an explanation of hardship.
Yes
No
2.
Was your household income (from section 2, line I) less than $21,644?
Yes
No
3.
Did you reside at your address for ten of the previous twelve months?
If you answered "Yes" to all three questions above, you qualify for the low income credit.
If you qualified for the low income credit, you may also qualify for the property tax credit on the reverse side.
For more information, contact your county government listed below
Beaver County
438-6463
Iron County
477-8333
Sevier County
896-9262 ext. 200
Box Elder County
734-3319
Juab County
623-0271
Summit County
336-4451 ext. 3254
Cache County
752-3414
Kane County
644-2458
Tooele County
843-3130
Carbon County
636-3200
Millard County
743-5227
Uintah County
781-5363
Daggett County
784-3210
Morgan County
829-6811
Utah County
370-8227
Davis County
451-3329
Piute County
577-2840
Wasatch County
654-3211 ext. 309
Duchesne County
738-1120
Rich County
793-5155
Washington Cnty
634-5712
Emery County
381-5106
Salt Lake County
468-3400
Wayne County
836-2731
Garfield County
676-8826 ext. 1109
San Juan County
587-3223
Weber County
399-8002
Grand County
259-1321
Sanpete County
835-2142
40CY.FRM Rev. 4/98
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