Fillable PTR-1 New Jersey 2019 Senior Freeze (Property Tax (The State of New Jersey)

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PTR-1 New Jersey 2019 Senior Freeze (Property Tax (The State of New Jersey)

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The PTR-1 New Jersey 2019 Senior Freeze (Property Tax (The State of New Jersey) form is 4 pages long and contains:

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  • 392 other fields

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This is a four-page application. You must complete all four pages. Fill in ovals completely.
PROOF OF AGE OR DISABILITY FOR 2018 AND 2019 MUST BE SUBMITTED WITH APPLICATION
Age 65 or Older: Copy of one – Birth Certicate, Driver’s License, Church Records
Receiving Federal Social Security Disability Benets: Copy of Social Security Award Letter
See instructions for more information.
Marital/Civil Union Status
1. Your Marital/Civil Union Status on December 31, 2018: Single Married/CU Couple
2. Your Marital/Civil Union Status on December 31, 2019: Single Married/CU Couple
Age/Disability Status
3a. On December 31, 2018, were you age 65 or older? Yourself Yes No
Spouse/CU Partner Yes No
3b. On or before December 31, 2018, were you actually Yourself Yes No
receiving federal Social Security disability benet Spouse/CU Partner Yes No
payments?
4a. On December 31, 2019, were you age 65 or older? Yourself Yes No
Spouse/CU Partner Yes No
4b. On or before December 31, 2019, were you actually Yourself Yes No
receiving federal Social Security disability benet Spouse/CU Partner Yes No
payments?
Applicant(s) must meet the age or disability requirements for both 2018 and 2019. If neither you nor your spouse/CU
partner met the requirements, you are not eligible for the reimbursement, and you should not le this application. See
“Eligibility Requirements” on page 1 of instructions.
Residency Requirements
5. Have you lived in New Jersey continuously since December 31, 2008,
or earlier as either a homeowner or a renter? Yes No
If “No,” STOP. You are not eligible for the reimbursement, and you should not le this application.
6. Have you owned and lived in the same New Jersey home since
December 31, 2015, or earlier? (Mobile Home Owners, see instructions) Yes No
If “No,” STOP. You are not eligible for the reimbursement, and you should not le this application.
Your Social Security Number
- -
Spouse’s/CU Partner’s SSN
- -
County/Municipality Code (See instructions)
Place preprinted label below ONLY if the information is correct.
Otherwise print or type your name and address.
Last Name, First Name, Initial (Joint Filers enter rst name and middle initial of each. Enter
spouse’s/CU partner’s last name ONLY if dierent.)
Home Address (Number and Street, including apartment number)
City, Town, Post Oce State ZIP Code
For Privacy Act Notication, See Instructions
New Jersey
2019 Senior Freeze
(Property Tax Reimbursement) Application
PTR-1
You must enter your Social Security number below
Name(s) as shown on Form PTR-1
Your Social Security Number
PTR-1 (2019) Page 2
Determining Total Income (Line 7): Enter your annual income for 2018. See “Income Standards” and “Determining Total Income” in
the instructions for information on sources of income and how to determine the amount to report. If you had no income in a category,
leave that line blank. Losses in one category of income cannot be used to reduce total income. If you have a net loss in any income
category, leave that line blank. If you were married or in a civil union as of December 31 of 2018 and living in the same home,
combine your incomes for that year. If you lived in separate homes, le as “Single.”
2018 Income
a. Social Security Benets (including Medicare Part B
premiums) paid to or on behalf of applicant. Enter total
amount from Box 5 of Form SSA-1099 or Form RRB-1099 ....... a. , .
b. Pension and Retirement Benets (including IRA and
annuity income) See instructions for calculating amount .......... b. , .
c. Salaries, Wages, Bonuses, Commissions, and Fees ................ c. , .
d. Unemployment Benets ............................................................. d. , .
e. Disability Benets, whether public or private (including
veterans’ and black lung benets) .............................................. e. , .
f. Interest (taxable and exempt) ...................................................... f. , .
g. Dividends ....................................................................................g. , .
h. Capital Gains ..............................................................................h. , .
i. Net Rental Income ....................................................................... i. , .
j. Net Prots From Business ........................................................... j. , .
k. Net Distributive Share of Partnership Income ............................ k. , .
l. Net Pro Rata Share of S Corporation Income ............................. l. , .
m. Support Payments ..................................................................... m. , .
n. Inheritances, Bequests, and Death Benets .............................. n. , .
o. Royalties .....................................................................................o. , .
p. Gambling and Lottery Winnings (including New
Jersey Lottery) ............................................................................p. , .
q. All Other Income .........................................................................q. , .
7. Enter total 2018 income on line 7. (Add lines a-q) ..................
7.
, .
Was your total 2018 income on line 7 $89,013 or less?
Yes. See 2019 income eligibility.
No. STOP. You are not eligible for the reimbursement, and you should not le this application.
Name(s) as shown on Form PTR-1
Your Social Security Number
PTR-1 (2019) Page 3
Determining Total Income (Line 8): Enter your annual income for 2019. See “Income Standards” and “Determining Total Income” in
the instructions for information on sources of income and how to determine the amount to report. If you had no income in a category,
leave that line blank. Losses in one category of income cannot be used to reduce total income. If you have a net loss in any income
category, leave that line blank. If you were married or in a civil union as of December 31 of 2019 and living in the same home, com-
bine your incomes for that year. If you lived in separate homes, le as “Single.”
2019 Income
a. Social Security Benets (including Medicare Part B
premiums) paid to or on behalf of applicant. Enter total
amount from Box 5 of Form SSA-1099 or Form RRB-1099 ....... a. , .
b. Pension and Retirement Benets (including IRA and
annuity income) See instructions for calculating amount .......... b. , .
c. Salaries, Wages, Bonuses, Commissions, and Fees ................ c. , .
d. Unemployment Benets ............................................................. d. , .
e. Disability Benets, whether public or private (including
veterans’ and black lung benets) .............................................. e. , .
f. Interest (taxable and exempt) ...................................................... f. , .
g. Dividends ....................................................................................g. , .
h. Capital Gains ..............................................................................h. , .
i. Net Rental Income ....................................................................... i. , .
j. Net Prots From Business ........................................................... j. , .
k. Net Distributive Share of Partnership Income ............................ k. , .
l. Net Pro Rata Share of S Corporation Income ............................. l. , .
m. Support Payments ..................................................................... m. , .
n. Inheritances, Bequests, and Death Benets .............................. n. , .
o. Royalties .....................................................................................o. , .
p. Gambling and Lottery Winnings (including New
Jersey Lottery) ............................................................................p. , .
q. All Other Income .........................................................................q. , .
8. Enter total 2019 income on line 8. (Add lines a-q) ..................
8.
, .
Was your total 2019 income on line 8 $91,505 or less?
(See “Impact of State Budget” on page 1 of instructions, which explains how the state budget may reduce the income limit.)
Yes. Go to page 4.
No. STOP. You are not eligible for the reimbursement, and you should not le this application.
Name(s) as shown on Form PTR-1
Your Social Security Number
Principal Residence
9. Status (ll in appropriate oval): Homeowner Mobile Home Owner
10. Homeowners: Enter the block and lot numbers of your 2019 principal residence.
Block Lot Qualier
. .
2018 2019
11a. Did you share ownership of this property with anyone other
than your spouse/CU Partner? (Mobile Home Owners, see instructions) ....
Yes No Yes No
11b. If you answered “Yes,” indicate the share (percentage) of the property
owned by you (and your spouse/CU partner) (Mobile Home Owners,
see instructions) ..........................................................................................
%
%
12a. Did this property consist of multiple units? ...................................................
Yes No Yes No
12b. If you answered “Yes,” indicate the share (percentage) of the property
that you (and your spouse/CU partner) used as your principal residence. . .
%
%
If you answered “Yes” at line 11a or 12a, see instructions before completing lines 13 and 14.
Property Taxes
Proof of Property Taxes Due and Paid for 2018 and 2019 Must be Submitted With Application. See Instructions.
If you are claiming property taxes for additional lots, check box. (See instructions)
13. Enter your total 2019 property taxes due and paid (including any
credits/deductions) on your principal residence. See instructions.
(Mobile Home Owners: Property taxes = total site fees paid X 0.18) .........
13.
, .
14. Enter your total 2018 property taxes due and paid (including any
credits/deductions) on your principal residence. See instructions.
(Mobile Home Owners: Property taxes = total site fees paid X 0.18) .........
14.
, .
Reimbursement Amount (See “Impact of State Budget” on page 1 of instructions.)
15. Reimbursement. (Amount to be sent to you. Subtract line 14
from line 13) ................................................................................................
15.
, .
If line 15 is zero or less, you are not eligible for a reimbursement, and you should not le this application.
PTR-1 (2019) Page 4
SIGN HERE
If enclosing copy of death certicate for deceased applicant, check box. (See instructions)
Due Date: November 2, 2020
Mail your completed application
to :
NJ Division of Taxation
Revenue Processing Center
Senior Freeze (PTR)
PO Box 635
Trenton, NJ, 08646-0635
Senior Freeze (PTR) Hotline:
1-800-882-6597
Under penalties of perjury, I declare that I have examined this Senior Freeze (Property Tax Reimbursement) Application,
including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and
complete. If prepared by a person other than applicant, this declaration is based on all information of which the preparer has
any knowledge.
Your Signature Date Spouse’s/CU Partner’s Signature (if ling jointly, BOTH must sign)
Your daytime telephone number and/or email address (optional)
Paid Preparer’s Signature Federal Identication Number
Firm’s name Federal Employer Identication Number
Division Use
1
2
3
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5
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7.
.
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PTR-1 New Jersey 2019 Senior Freeze (Property Tax (The State of New Jersey)

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Completed 4 August 2020

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