Form 538-H - Claim For Credit Or Refund Of Property Tax - 2012
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1
2State of Oklahoma
Claim for Credit or Refund of Property Tax
This form is due on or before July 1, 2013.
2
538-H
0
Taxpayer first name, middle initial and last name
1
2
Spouse’s first name, middle initial and last name (if a joint return)
Taxpayer Social
Security Number:
Present home address (number and street, including apartment number or rural route)
Spouse’s Social
Security Number:
City, State and Zip
(
)
Phone Number:
Part 1: Qualification Questions
A:
Were you a resident of Oklahoma for all of the year? ....................
Yes
No
(if you marked “no” on line A,
do not file this form)
B:
Are you or your spouse 65 or over? If no, answer question “C” .....
Yes
No
(if you marked “no” on both lines B and C,
C: Were you totally disabled for the full year?
..
Yes
No
do not file this form)
If yes, please submit proof
D: Are you required to file an Oklahoma Income Tax return this year?
Yes
No
Note: If “yes” on line D, this claim MUST be
enclosed with and credit claimed on Form 511.
Part 2: Gross Household Income
(Round to Nearest Dollar)
Enter TOTAL GROSS income and assistance, taxable and nontaxable, received by ALL members
Yearly Income
of your household in 2012.
You may not enter negative amounts
1. Enter total wages, salaries, fees, commissions, bonuses, and tips
1
(including nontaxable income from your W-2) ........................................................................
00
2
00
2. Enter total interest and dividend income received .................................................................
3
3. Total of all dependents’ income ..............................................................................................
00
4
4. Social Security payments (total including Medicare) ..............................................................
00
5
5. Railroad Retirement benefits ..................................................................................................
00
6
00
6. Other pensions, annuities and IRAs .......................................................................................
7
7. Alimony ...................................................................................................................................
00
8
8. Unemployment benefits ..........................................................................................................
00
9
9. 2011 Earned Income Credit (EIC) received in 2012................................................................
00
10
00
10. Nontaxable sources of income (specify) ________________________________ ................
Examples of nontaxable sources of income are: Veteran’s disability payments, worker’s compensation,
You may not enter negative amounts
loss of time insurance, support money and public assistance (housing assistance, cash, etc.)
11. Enter gross (positive) income from rentals, royalties, partnerships, estates & trusts, and gains
from the sale or exchange of property
(taxable and nontaxable) (enclose Federal return including schedules) .
11
00
12. Enter gross (positive) business and farm income (enclose Federal return including schedules)....
12
00
13. Other (specify) _____________________________________ .............................................
13
00
14. Total gross household income
00
(Add lines 1-13) If over $12,000, STOP, you don’t qualify for the credit or refund.
14
Part 3: Gross Household Income of $12,000 or Less
15. Enter the amount of 2012 real estate taxes paid on your homestead ......................................
00
15
A copy of your tax bill must be enclosed with this claim form.
16. To compute credit or refund allowable: Multiply the amount of total household income from
Part 2, line 14: $ ___________________ X 1% (0.01). Enter result here ..............................
16
00
17. Amount of credit or refund, subtract line 16 from line 15 (not to exceed $200) .......................
17
00
18. If you are required to file an Oklahoma Income Tax return, enter the amount
from line 17 here and as a credit on Form 511 .........................................................................
00
18
19. If you are NOT required to file an Oklahoma Income Tax return, enter the amount from line
17 here.
............
(This amount will be refunded either by direct deposit or debit card; see instructions)
00
19
Direct Deposit Option:
For those NOT filing a Form 511.
(See page 2 to see if you qualify for Direct Deposit)
Deposit my refund in my:
Routing
Is this refund going to or through an
Number:
checking account
account that is located outside of
the United States?
Account
Yes
No
savings account
Number:
Under penalty of perjury, I declare the information contained in this document and any attachments is true and correct to the best of my knowledge and belief.
Spouse’s Signature and Date
Claimant’s Signature and Date
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