Fillable Disability Exemption Program Assessment Division (Sussex County Council)

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Disability Exemption Program Assessment Division (Sussex County Council)

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Revis
ed 4/2020
Sussex County
Assessment Division
PO Box 589
Georgetown, DE 19947
Phone: (302) 855-7762
sussexcountyde.gov
Assessment Division
Disability Exemption Program
Thank you for your interest in the Disability Exemption Program. The qualifications for the program are
on the attached form. If your application is approved, the exemption will be effective for the fiscal year
beginning July 1, 2020 through June 30, 2021.
PLEASE READ THE QUALIFICATIONS ON THE APPLICATION FORM CAREFULLY.
If you qualify, remit ALL that apply. INCOMPLETE FORMS WILL NOT BE PROCESSED.
.
☐ Complete the form and sign it.
☐ Send copy of Delaware Driver’s License or official State ID.
☐ Return the application form with a copy of your 2019 Federal Tax Form.
☐ Schedule A, C
☐ Schedule D (Profit/Loss)
☐ Schedule E (Rental)
☐ If you do not file a Federal Tax Form, then attach:
☐ a COPY of 2019 Social Security Benefit Statements.
☐ a COPY of 2019 Interest Statements.
☐ a COPY of 2019 Pension Statements.
☐ and the last year you did file Federal Income Taxes
☐ Recent copy of Bank Statements.
☐ 4506-T Form must be signed and returned.
If you have any questions, please call (302) 855-7853 or email brittany.droney@sussexcountyde.gov.
All applications must be received in the Assessment Division before April 30, 2020.
SUSSEX COUNTY
QUALIFICATIONS FOR DISABILITY EXEMPTIONS
Those persons who meet the following requirements should file an application with the
Assessment
Division by April 30, 2020.
1. The applicant has been a full-time resident in Sussex County for at least five (5) full
years i
mmediately preceding the application;
2. The applicant is the owner of the real property and the dwelling for which such
exemption is claimed;
3. The applicant resides in said dwelling;
4. The applicant can be exempt only on property on which he or she lives;
5. The applicant’s income is not in excess of Six Thousand Dollars ($6,000) or, in the event
of a marriage and/or civil union, the combined income for husband and wife is not in
excess of Seven Thousand Five Hundred Dollars ($7,500) a year;
6. Income in #5 above shall not include Social Security benefits or Railroad Retirement
benefits (Tier 1 only);
7. Proof of Income (Federal Income Tax Form 1040). Income used is adjusted gross
income as reported on your Federal Tax Form. This would be income for the previous
calendar year.
8. The applicant is totally disabled and has secured the signature of a medical doctor in
support of such claim;
9. A person shall be considered totally disabled who, as a result of an accident, injury, or
disease, shall permanently be physically prevented from pursuing any remunerative
occupation.
____________________________________________________________________________
• If the application is approved, the maximum amount of the exemption is $12,500
subtracted from your total assessment. The remainder of the assessment (if any) is
taxable.
• Any property subject to a Ditch Tax is still taxable.
• If you own the property with anyone other than your spouse, you will be exempt on your
percentage of the total assessment up to $12,500.
• NO APPLICATION SHALL BE APPROVED UNLESS ALL TAXES, USER FEES,
SEWER SERVICE CHARGES, AND ALL OTHER TAXES AND FEES THEN DUE TO
OR COLLECTIBLE BY SUSSEX COUNTY HAVE BEEN PAID IN FULL FOR ALL
PARCELS OWNED BY THE APPLICANT BEFORE THE APPLICATION DEADLINE.
• We reserve the right and will execute the same, to verify income and residency.
• You will be notified if your application is denied.
Phone: (302) 855-7762
sussexcountyde.gov
Sussex County
Assessment Division
PO Box 589
Georgetown, DE 19947
APPLICATION OF DISABLED PERSONS FOR TAX EXEMPTION
MAP PARCEL UNIT
DISTRICT
Applicant’s Name:
Applicant’s Address:
Birthdate: Phone Number: Applicant's SSN:
Co-Owner’s SSN: Email Address (for application updates)
Date on which you became a primary resident of Sussex Count
y:
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
Income of preceding year: Jan. 1, 2019 thru Dec. 31, 2019. Do not include Social Security or Railroad Pension Tier 1.
HUSBAND
WIFE
Pension
Dividends & Interest
Wages or Salaries
Other Sources of Income:
Rents, Sale of Property
Farm Income
Yearly Income
State (Attach a copy of your 2019 Federal 1040 Form.) I filed Income Tax Returns: Federal
If no longer filing income taxes, last date filed:
If no longer filing, please verify by signing:
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:
For purposes of this exemption, a person shall be considered totally disabled whom as a result of accident, injury, or
disease, shall permanently be physically prevented from pursuing any profitable occupation.
THE PHYSICIAN’S CERTIFICATE BELOW MUST BE COMPLETED.
FOR PHYSICIAN ONLY
, as a result of accident, injury, or disease is permanently I certify that
prevented from pursuing any profitable occupation.
Physician’s Name:
Address:
Phone #:
Approved/Disapprov
ed: Date:
Physician's Signature
Yes No
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Disability Exemption Program Assessment Division (Sussex County Council)

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Completed 18 July 2020

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