District of Columbia Cancellation of Homestead Deduction - Senior Citizen/Disabled Tax Relief

Cancellation of Homestead Deduction - Senior Citizen/Disabled Tax Relief
Microsoft Word - CANCELLATIONOFHOMESTEADDEDUCTION Nov 14 edits(clean) (2).docx
Government of the
District of Columbia

ASD-105 Cancellation of Benefits Form

Print in CAPITAL letters using black ink. Leave lines blank that do not apply.

Please Cancel My:
(Select one only)

*001050110000*

HOMESTEAD DEDUCTION

SENIOR CITIZEN/DISABLED TAX RELIEF

LOWER-INCOME TAX EXEMPTION

TAX DEFERRAL



PART 1 – PERSONAL INFORMATION
Owner Social Security Number SSN

Co-owner SSN

Owner First Name

M.I.

Last Name

Co-owner First Name

M.I.

Last Name

Current mailing address (number and street)

City

State

Zip Code +4

Email address

PART 2 – PROPERTY INFORMATION
Quadrant

Property address (number and street)-REQUIRED

Square

Suffix

Unit Number

Lot

Zip Code +4

PART 3 – CANCELLATION REASONS
1. The property is no longer owner's principal place of residence..................................................................................................................... 1.
2. Owner(s) no longer meet(s) age, disability or domicile requirement.......................................................................................................... 2.
3. Total household federal adjusted gross income for Senior Citizen/Disabled Property Tax Relief is equal to or less than $135,750 TY 2021....... 3.
4. Owner(s) is /are deceased [please attach a copy of the death certificate(s)]................................................................................................. 4.
5. No longer own home............................................................................................................................................................................. 5.
6. Total household federal adjusted gross income for Tax Deferral Program is not less than $50,000.................................................................... 6.
7. Total household federal adjusted gross income for Lower Income Homeownership Exemption Program is not less than noted on
Qualifying Income Table (see Form ROD-9 Lower Income Homeownership Exemption Program)................................................................ 7.
8. Other (specify)________________________________________________________________________________________________________________________________________ 8.

ENTER DATE WHEN THE ABOVE EVENT OCCURRED OR WILL OCCUR (mmddyyyy)

PART 4 – SIGNATURE

Under penalties of law, I declare that I have examined this Statement (and any attachments) and, to the best of my knowledge, it is
correct. Making a false statement is punishable by criminal penalties under the District of Columbia Official Code 47-4106 and
22-2405.
Owner signature

Printed First name

Date (mmddyyyy)

M.I.

Daytime phone

Last name

If you have further questions, you may reach us at (202) 727-4TAX(4829), FAX: (202) 442-6691, WEBSITE: MyTax.DC.gov

MAIL TO: Office of Tax and Revenue, 1101 4th Street SW, 4th Fl, Washington, DC 20024



Form ASD-105 (Rev. 02/2021)



GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
OFFICE OF TAX AND REVENUE

Benefit Cancellation Instructions
Use this form to notify the Homestead and/or Special Programs Unit of the Office of Tax and Revenue (OTR) that a property is no longer eligible to receive the Homestead,
Senior Citizen/Disabled, Lower-income homeownership exemption or Tax Deferral property benefit. Property that is not eligible for the Homestead Deduction is not eligible
for the owner-occupant residential tax credit (assessment cap credit).
In the event a property loses eligibility for one or more of these benefits, the person who applied for the benefit or the current owner of the property must provide written
notification to OTR’s Homestead/Special Programs Unit within 30 days of the change in eligibility. Property can lose its eligibility for the Homestead, Senior Citizen or
Disabled property benefit if the property or its owners fail to meet any of the applicable requirements. Loss of eligibility may result if the ownership changes or if the owner
moves out of the property or loses District domicile. Please see OTR Tax Notice 2015-07 for guidance on eligibility for the Homestead Deduction and related real property
tax relief programs.
If the tax is paid within 30 days of the corresponding bill, timely notification of loss of eligibility will preclude imposition of penalty and interest. If timely written
notification is not made, a penalty of 10% of the delinquent tax and 1.5% interest on such tax for each month that the property wrongfully received the benefit(s) may be
imposed.
If a property loses eligibility during the first half of the tax year (October 1-March 31), the benefit is generally rescinded for the full tax year. If loss of eligibility occurs
during the second half of the tax year (April 1-September 30), the benefit generally will be rescinded for the second half of the year only. However, if property is transferred
to a new owner who does not qualify for the Homestead Deduction, the Deduction shall be removed at the end of the half tax year during which the transfer occurred.
Property owners may not receive any of these benefits on more than one lot. If you move to a new home, you should notify OTR’s Homestead or Special Programs Unit to
cancel the present benefit and apply for the benefit for the new home. Notification is not necessary if the transferred property (your old home) qualified for the benefit 30 days
or less before the date of execution of the deed of transfer.
Household Income Limit for Senior Citizen/Disabled Benefit Property is not eligible for the Senior Citizen/Disabled benefit for the TY 2021 real property tax year
(October 1-September 30) if household federal adjusted gross income for 2019 equals or exceeds the income threshold of $135,750. The household includes the grantor of a
revocable trust who continues to reside in the property or the beneficiary of a special needs trust.
To determine whether the income threshold is exceeded, the federal adjusted gross income of all members of the household (excluding tenants occupying the property under
written leases for fair market value) is counted, using each member’s federal income tax year which ended immediately prior to the beginning of the real property tax year for
which the benefit is to be applied. For example, to determine eligibility for the real property tax year beginning October 1, 2020, the household members' federal adjusted
gross income for the 2019 federal income tax year, which generally ends December 31, 2019, would be counted.
Household Income Limit for Tax Deferral Benefit If your total household Federal Adjusted Gross Income (AGI) is $50,000 or greater, you do not qualify for the lowincome or low-income senior citizen property tax deferral. In order to qualify for the Senior Citizen Low-Income tax deferral benefit at 0% interest, household interest and
dividend income cannot equal or exceed $12,500.
Domicile Only property owned and occupied by a District domiciliary can qualify for these benefits. If the owner/occupant no longer makes the District his or her permanent
home, the property loses eligibility for benefits. Evidence that the District is the owner’s permanent home, includes, as applicable, a DC driver’s license/identification card,
DC vehicle registration and DC voter registration. Withholding of DC income tax from salary or wages or filing a District of Columbia Income Tax return can also be
evidence of domicile.
Change of Principal Residence If a property is no longer the principal place of residence in the District of its record owner or eligible trust beneficiary, the property loses
eligibility for these benefits. A property rented to tenants and no longer occupied by the owner or trust beneficiary is not the principal residence of the owner.
Death of Owner If the record owner occupying the property dies, or the grantor of a revocable trust or the beneficiary of a special needs trust who resided in the property
dies, the property loses eligibility for these benefits. The property will generally not qualify for any of these benefits until record title is placed in the name of an individual
who resides in the property or an eligible trust, an application is filed and the property otherwise qualifies for the benefit.

Form ASD-105 Rev. (02/2021)