Phone: (302) 855-7762
sussexcountyde.gov
Sussex County
Assessment Division
PO Box 589
Georgetown, DE 19947
APPLICATION OF CITIZEN OVER 65 FOR TAX EXEMPTION
MAP PARCEL UNIT
DISTRICT
Applicant’s Name:
Applicant’s Address:
Birthdate: Phone Number:
Applicant’s SSN: Co-Owners SSN:
Date on which you became a primary resident of Sussex County:
Is any portion of this property used for any purpose other than your own residence?
If yes, explain:
I own the above property: Solely
Jointly in Common (see below)
NAME RELATIONSHIP ADDRESS BIRTHDATE
HUSBAND WIFE
Pension
Dividends & Interest
Wages or Salaries
Other Sources of Income:
Rents, Sale of Property
Farm Income
Yearly Income
Person to contact for additional information:
Phone #:
I hereby swear or affirm that this information is true and correct to the best of my knowledge and belief, and further
understand that a false declaration in this application will subject me to the penalties provided by the law for perjury.
I hereby authorize the Finance Department to verify any information relating to my eligibility with the IRS, the State
Division of Revenue, or any other governmental agency.
Signature of Applicant: Date:
Approved/Disapprov
ed: Date:
Yes No
Income of
preceding
year:
Jan.
1,
2020
thru
Dec.
31,
2020.
Do
not
include Social
Security or
Railroad
Pension
Tier
1.
I
filed Income
Tax
Returns:
Federal
State
(Attach
a
copy
of
your
2020
Federal
1040
Form.)
If
no
longer
filing income taxes,
last
date filed:
If
no
longer
filing,
please verify
by
signing:
