nm3clol-public/Russell_County/Commissioner_of_Revenue/Tax%20Relief%20Form/README.md

type	title	file	tags	docDate	contentType	contentLength	sha256sum	sha1sum
document	Tax%20Relief%20Form	../Tax%20Relief%20Form.pdf	Russell_County Commissioner_of_Revenue	null	application/pdf	243318	3596d764bf6229ea25dc082b08086695c2a7643c3e953ae02b3f06da8ffe44e3	8e7259037ce5f0938991358ff99434774f3bdd85

County of Russell

Commissioner of the Revenue

LEBANON, VIRGINIA 24266 PHONE: 276-889-8018

APPLICATION FOR REAL ESTATE TAX EXEMPTION FOR ELDERLY & DISABLED HOMEOWNER.

Read Requirements for Exemption on Page 4

‘The information required on this application must be filled out in its entirety and returned to the Commissioner of Revenue, Lebanon, Virginia. Applications must be filed by March 1 of the taxable year for which the exemption is applied, Complete all spaces on application that are applicable. Questions that cannot be answered within the spaces provided may be answered by attaching additional sheets to this application. This exemption is granted on an annual basis and a new application must be filed each year.

All information on the application is confidential and not open to the public inspection.

Applicant: Tost Name Fist ale Mailing Address: Birthdate: Social Security No.: Mo, Day Year Spouse: Tat Name Hint "alate Birthdate: Social Security No.: We Day Year

Name under which property is listed and appears on the tax bill, if different form the applicant or spouse’s name.

Location and description of property:

(A) Acreage and/or (B) Subdivision Lot Block Section (District. Description, (D) Map No. FOR OFFICE USE ONLY L INCOME _ NET WORTH. ASSESSED VALUE | AMOUNT OF TAX

Date Received Page 1

| |

1, Isthis dwelling occupied by the applicant as the sole dwelling? Yes

2, Isthe applicant (Owner) [1

If partial ownership, explain how the ownership is legally hel

(Partial Owner) G

I. OCCUPANCY AND OWNERSHIP

No O

sd and the proportion owned by the applicant.

4, _Listthe names, relationship and Social Security Number ofall persons related tothe applicant who occupy the above dwelling: Name Relationship Social Security No. @. @. @). II. GROSS INCOME

Please complete this gross income statement for

the immediately preceding calendar year. Included in this statement should

be the total gross income from all sources ofthe applicant and spouse and each relative living in the dwelling,

SOURCE

APPLICANT

SPOUSE

RELATIVE (1) | RELATIVE @)

RELATIVE 3)

per Salaries, Wages, Etc.

Pensions

Social Security

Interest and Dividends

Rental Income

Public Assistance

Other Income

Less Exclusions(s) for Relative(s) Income

‘Total Gross Income for Bach

‘Total combined income of the Applicant, Spouse, and Relatives.

Page 2

I. NET WORTH

Please complete this statement of net financial worth as of December 31* of the immediately preceding calendar year.

INOTE: Exclude the fair market value of the house and the land upon which| jit is situated not exceeding one acre. The asset (fair market value) and) liability (mortgage) on the exempted property should not be included in the}

computation of New Worth. ‘ ASSETS APPLICANT SPOUSE OTHER OWNERS AND THEIR SPOUSE(S) scnincemaner rT

Real Estate (other than residence)

‘Tangible Personal Property (includes household goods)

Automobile(s) air Market Value)

‘Cash on hand and in Bank

Stocks and Bonds

Life Insurance and Annuity (Cash Value)

Other Assets

soar TOTAL ASSETS

NOTE: Changes in respect to income, financial worth, ownership of property| lor other factors occurring during the taxable year for which the affidavit is filed and having the effect of exceeding or violating the limitations and conditions provided herein, or by any ordinance adopted hereafter, shall nullify any exemption for the then current taxable year and the taxable year

immediately following.

I certify, under the penalties provided by law, that this application for Real Estate Tax Relief for the Elderly & isabled Homeowner, including any accompanying schedules or statements, to the best of my knowledge and belief

CERTIFICATE,

is true, correct and complete. Applicant's Signature Date Signature of Spouse Date Telephone

Page 3

COUNTY OF RUSSELL

Commissioner of the Revenue

REQUIREMENTS FOR REAL ESTATE TAX EXEMPTION FOR ELDERLY AND DISABLED HOMEOWNER AS AUTHORIZED BY THE COUNTY OF RUSSELL ORDINANCE. ,

1

1. Thetitle of the property for which exemption is claimed must be held, or partially held, on January 1 of the taxable year, by the person or persons claiming exemption.

2. ‘The head of the household occupying the dwelling and owning title, or partial title thereto, must be sixty-five years or older or permanently disabled on December 31 of the year immediately preceding the taxable year, ‘Such dwelling must be occupied as the sole dwelling'of the persons not less than sixty-five years of age or permanently disabled. :

3. The Gross Combined Income of the owner(s) during the year immediately preceding the taxable year shall be determined by the Commissioner of Revenue in an amount not to exceed $30,000.

4. The total combined net financial worth of the owner as of December 31 of the year immediately preceding the taxable year shall be determined by the Commissioner of Revenue to be an amount not to exceed $80,000.00. ‘Total net financial worth shall include all assets, including equitable interest, of the owner in the dwelling for which exemption is claimed, and shall exclude the fair market value of the dwelling and the land, not exceeding ‘one acre, upon which the dwelling is situated.

5, Annually, and not later than March 1 of the taxable year, the person or persons claiming an exemption must file a real estate tax exemption application with the Commissioner of Revenue,

6. Sec. 00-6 Amount of Exemption. For qualified persons, the amount of exemption of, the real estate tax shall be $165.00 of the tax bill, The

difference between the original tax and the figure arrived at will be due the County as the assessed property tax for that year, In no case will the tax excused exceed $165.00.

"The exemption shall be administered by the Commissioner of Revenue according to the provisions of this Ordinance. The Commissioner of Revenue is hereby authorized and empowered to prescribe, adopt, promulgate and enforce rules and regulations in conformance with the provisions of this ordinance, including the requirement of answers under oath, as may be reasonably necessary to determine qualifications for exemption as specified by this Ordinance. ‘The Commissioner of Revenue may require the production of certified tax returns and appraisal reports to establish income and/or financial worth.

INOTE: The false claiming of the exemption authorized in this section shall constitute a misdemeanor; any person convicted of falsely claiming such exemption shall be punished by a fine not Jess than Twenty-Five Dollars ($25.00) or more than Two Hundred Fifty [Dollars ($250.00) for each offense.

Randy N. Williams Russell County Commissioner of Revenue P.O. Box 517 Lebanon, Virginia 24266

Page 4