ANN HARRIS BENNETT
Tax Assessor-Collector & Voter Registrar
PT-DQP-17 www.hctax.net Rev 11/17 v8
Request for Installment Agreement for Taxes on Property in a Disaster Area
This application is ONLY for the 2017 real and tangible personal property taxes for property in Harris County damaged by the
severe weather, tornadoes and flooding caused by Hurricane/Tropical Storm Harvey that began on August 25, 2017 in the
State of Texas.
Please see ‘Qualificationson next page to verify you are eligible for this benefit.
The application and first payment MUST be made or post-marked no later than January 31, 2018 (or the due date on your
Tax Statement, if anything other than January 31, 2018). All payments may be paid by mail, in person, online (www.hctax.net) or
by phone at 713-274-2273 (CARD). Payments are calculated by taking the total amount due and dividing by four (4).
TAXPAYER INFORMATION
Taxpayer Name:
Property Tax Account Number:
Email:
Phone Number:
Fax Number:
Property Address and Legal Description:
Mailing Address of Owner (if different from above):
To avoid penalty and interest, taxpayers must pay at least one-fourth of the total amount due by January 31, 2018. Taxpayers
who make their first payment in the one-month grace period after the delinquency must include an additional 7%, penalty and interest
with that payment. Please contact us at 713-274-8120 if you have questions or need assistance in calculating your payment.
PROOF OF LOSS
Please attach any of the following documents to this form as proof of loss: FEMA or insurance claim sheet, photos of the
damage, or copy of repair estimate.
Mail with first payment to:
Harris County Tax Assessor-Collector’s Office
Special Tax Services Department
PO Box 3746
HOUSTON, TEXAS 77253-3746
You will be notified by mail ONLY if your request is NOT approved.
If you opted to make your first payment online or by phone, please list your Harris County Tax Assessor-Collector’s
Office payment confirmation number below:
Confirmation #
By signing this application, I affirm under penalty of perjury that all information above and documents provided as evidence of
damage are applicable to the property as listed above, are accurate and factual, and occurred as a result of severe weather,
tornadoes and flooding caused by Hurricane/Tropical Storm Harvey that began on August 25, 2017 in the State of Texas.
Signature Printed Name Date
ANN HARRIS BENNETT
Tax Assessor-Collector & Voter Registrar
PT-DQP-17 www.hctax.net Rev 11/17 v8
Installment Payment Plan For Disaster Victims
In accordance with Section 31.032 of the Property Tax Code, taxpayers who sustained property
damage as a result of a declared natural disaster may be eligible to split their property tax payments
into 4 equal penalty and interest free installments, to be paid in full by July 31st.
Qualifications
This only applies to taxes imposed between the date of the disaster (8/25/17) and exactly one year after
(8/25/18) for:
1. real property that is -
a. the residence homestead of the owner or consists of property that is used for residential
purposes and that has fewer than five living units; or
b. owned or leased by a business entity that had not more than the amount calculated as provided
by Subsection (h) in gross receipts in the entity's most recent federal tax year or state franchise
tax annual period, according to the applicable federal income tax return or state franchise tax
report of the entity.
Note: The gross receipts threshold used in determining eligibility is $5,704,890.
c. located in a declared disaster area; and
d. damaged as a direct result of the disaster.
2. tangible personal property owned or leased by a business entity as described in (b), above.
Requirements
1. Payment of at least one-fourth (25%) of the total amount of taxes due must be made before the
due date shown on your tax statement. (January 31st, unless your account was late-certified).
Note: Taxpayers have a one-month grace period after the delinquency date to make the first
payment. Penalty and interest totaling 7% will be added to the amount due.
2. This Request for Installment Agreement for Taxes on Property in a Disaster Area form must
be completed and mail to: Tax Assessor- Collector, PO Box 3746 - HOUSTON, TEXAS 77253-3746.
3. Proof of the property damage in the form of FEMA or insurance claim sheet; photos of the
damage, copy of repair estimate, or paid invoices.
You will be notified by mail ONLY if your request is NOT approved.
Payments
If the first installment is paid by January 31, 2018, the remaining taxes due may be paid without penalty
or interest as follows:
The second installment must be paid by March 31, 2018.
The third installment must be paid by May 31, 2018.
The fourth installment must be paid by July 31,
2018.
Note: If you are late certified and your delinquency date is anything other than February 1, 2018,
then your future payment due dates will be based on the delinquency date.
If these installments payment on are not made before each of the deadline (delinquency) dates above,
the unpaid amount of the individual installment payment due is delinquent and incurs a penalty of 6%
and 1% interest as provided by Section 33.01(c) of the Property Tax Code. If you pay more than the
amount due for an installment then the excess will be credited to the next installment.