Alison H. McCoy
Tooele County Auditor
47 South Main Street #204
Tooele, UT 84074
Phone: (435) 843-3312
Fax: (435) 843-3309
Tax Relief Program: You Must Complete: Beneficiary:
Circuit Breaker Low-income age 66 & older, or surviving spouses
County Hardship Low-income, in extreme hardship, or disabled
Disabled Veteran Veterans with 10% or greater disability
Active Duty Military Military with 200+ days active duty service
Blind Exemption
Sections 1, 2, 4, 8
Sections 1, 3, 4, 8
Sections 1, 5, 8
Sections 1, 6, 8
Sections 1, 7, 8,
Legally blind with vision no more than 20/200
I am a homeowner age 66 or older by December 31, 2020,
OR I am an unmarried surviving spouse (widow/widower).
(New applicants must provide a copy of spouse’s death
certificate.)
I OWNED and OCCUPIED my residence on January 1, 2020
I will be a resident of Utah for all of 2020.
My household income in 2019 was less than $34,167.
I supplied at least 50% of my own financial support in 2019 and no one may claim me as a dependent in 2019.
Provide documentation of disability or hardship. First-time applicants living with a disability must provide a
physician’s medical statement verifying the disability. Those applying for a hardship abatement must provide a
letter explaining th
e situation, as well as any bank/investment/asset statements as of December 31, 2019.
I am age 65 or older by December 31, 2020,
OR I am under age 65 and disabled.
OR I am under age 65 and not disabled, but I am experiencing extreme hardship and will be unable to pay the
property taxes when they’re due without tax relief.
I will be living in the residence for at least ten (10) months in 2020.
My household income in 2019 was less than $34,167.
If applying for hardship abatement:
I do not own income-producing assets that could be sold to pay the tax when due.
I have not transferred assets or made gifts of property to any relative or trust fund within the past 3
Continue on next page.
2020 Property Tax Relief Application
(Office Use Only)
Date
Received: _______________________________
Entered: _______________________________________
Instructions
Application Deadline: The early deadline for this application is September 1, 2020.
A new application must be
filed each year.
Where to Submit: Submit this application to the Tooele County Auditor. You may submit by mail, email, fax, or in
person to the address listed above.
SECTION 1: APPLICANT INFORMATION
(All applicants must complete.)
Pro
p
ert
y
Parcel ID: Account Number:
If the property
is held in
a trust and the current trust agreement is not on file
with the Auditor's Office, you must provide
a copy of the trust
agreement before relief may be
granted.
SECTION 2: CIRCUIT BREAKER REQUIREMENTS
(Also complete sections 4 and 9.)
SECTION 3: COUNTY HARDSHIP REQUIREMENTS
(Also complete sections 4 and 9.)
Last Name First Name Initial Birth Date Social Security Number
Spouse Last Name First Name Initial Birth Date Death Date Social Security Number
Property Address City, State, Zip
Mailing Address, if different
Phone Number Email Address
Please choose the tax relief program(s) for which you are applying, and complete the appropriate sections:
Print Form
Save Form
Include ALL 2019 income of ALL persons living in the home. Attach copies of all 2019 year-end income
statements. Attach copies of federal tax returns including all schedules and attachments.
CHECK HERE if you did not file a 2019 Federal Tax Return.
(If non-filer, please supply copies of all 1099’s: social security, pensions, interest, dividends, IRA, 401(k) withdrawals for
EACH household member. OR submit an IRS wage and income transcript AND a verification of non-filing letter.)
1. Wages, Salaries, other Employee Compensation $_________________________________
2. Business, Farm, Rent, Partnership, Sale of Property or Miscellaneous Income $_________________________________
3. Social Security, Railroad Retirement, or Military Retirement: $_________________________________
4. Pensions, Annuities, IRA, 401(k), other Retirement $_________________________________
5. Dividends, Interest, or Trust Income Received $_________________________________
6. Capital Gains not listed above $_________________________________
7. TANF, Worker’s Compensation, Alimony, Child Support, and Strike Benefits $_________________________________
8. Other Income not listed above from all household members $_________________________________
TOTAL 2019 HOUSEHOLD INCOME (Add lines 1 through 8): $_________________________________
Note: NEW applicants and those with a percentage change of disability must provide a letter dated within the last
8 months showing the %
of disability and an effective date of January 1, 2020 or earlier.
I have a combined percentage of disability certified by the Veterans Administration as ____________%
OR I am the unmarried surviving spouse of a qualifying veteran and will provide a surviving spouse letter from
the VA that shows the veteran’s disability rating.
OR I am the unmarried surviving spouse of a veteran who was killed in action or died in the line of duty.
(New applicants please submit a copy of DD Form 1300, Report of Casualty, or other evidence of service-connected death.)
I OWNED and OCCUPIED my residence on September 1, 2020 and this property is my primary
residence.
Note: Must provide military orders, DD214, or letter from commanding officer confirming dates of service.
I completed at least 200 days of active duty service outside the state of Utah in 2020.
OR
I completed at least 200 consecutive days of active duty service outside the state of Utah across 2019-2020, provided
those days were not counted as qualifying days for tax relief in a prior year.
Note: New applicants must provide a letter from a licensed ophthalmologist verifying visual acuity as listed below.
Letter must be updated every ten years.
I am visually impaired with no more than 20/200 visual acuity in my better eye when corrected; or in the case of better
than 20/200 central vision, have a restriction of the field of vision in the better eye which subtends an angle of vision no
greater than 20 degrees.
OR I am the unmarried surviving spouse or minor orphan of a deceased blind person.
I OWNED and OCCUPIED my residence on January 1, 2019 and this property is my primary residence.
I hereby certify that I have not applied for property tax relief in any other county in Utah.
I/we declare that the information provided herein is complete, true, and correct. I/we understand that the information
provided is subject to verification by Tooele County, and I/we authorize Tooele County to receive and/or inspect
confidential tax, banking, and investment information from any government office or financial institution.
Applicant Date
Spouse
Date
SECTION 4: HOUSEHOLD INCOME
SECTION 5: DISABLED VETERAN EXEMPTION REQUIREMENTS
SECTION 7: BLIND EXEMPTION REQUIREMENTS
SECTION 8: CERTIFICATION & SIGNATURE
SECTION 6: ACTIVE DUTY MILITARY EXEMPTION REQUIREMENTS
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