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District of Columbia Senior/Disability Tax Benefit Statement of Income
Extracted from PDF file 2023-district-of-columbia-tax-benefit-statement.pdf, last modified November 2014Senior/Disability Tax Benefit Statement of Income
Government of the District of Columbia *001060110000* ASD-106 Statement of Income Print in CAPITAL letters using black ink. Leave lines blank that do not apply. THIS IS FOR: SENIOR CITIZEN/DISABLED TAX RELIEF LOWER-INCOME REAL PROPERTY TAX DEFERRAL PART 1 – PERSONAL INFORMATION Owner Social Security Number SSN Owner First Name M.I. Last Name Email address PART 2 – PROPERTY INFORMATION Quadrant Property address (number and street)-REQUIRED Square Suffix Unit Number Lot Zip Code +4 PART 3 – INCOME INFORMATION The program applied for requires verification of Federal Adjusted Gross Income (Fed-AGI) of the owner of record and all household members (excluding tenants under lease). An incomplete Statement will be returned for completion before any property tax benefit is granted. TAX YEAR Fed-AGI $ $ $ $ . . . . Tax years not required to report: _______________, _______________, _______________, _______________. If you are not legally required to file Federal or DC income tax returns, please attach a written copy of the reason(s) to Statement of Income 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-106 (Rev. 09/2020) GOVERNMENT OF THE DISTRICT OF COLUMBIA OFFICE OF THE CHIEF FINANCIAL OFFICER OFFICE OF TAX AND REVENUE DEFINITION of Member of Household Household members are all the people you live with (excluding tenants with a written lease for fair market value) whether or not they are related to you. For example, if you live in a house where you share the kitchen and bathroom with one or more persons, they are household members. DEFINITION of Household Federal Adjusted Gross Income (FED AGI) The definition of Household Federal Adjusted Gross Income (FED AGI), in effect since Oct. 4, 2011 as DC Law 19-165, is the following: "Household adjusted gross income" means the adjusted gross income of all persons residing in a household, as determined by each person’s federal income tax year ending immediately before the beginning of the real property tax year during which the deduction provided under subsection (b) of this section shall be applicable, excluding the adjusted gross income of any person who is a tenant by virtue of a written lease for fair market value. If you have further questions, you may reach us at (202) 727-4TAX(4829), FAX: (202) 442-6691, WEBSITE: MyTax.DC.gov Form ASD-106 Rev. (09/2020)
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More about the District of Columbia Tax Benefit Statement Other TY 2023
Income AGI Certification Form, Used for Senior/Disability Tax Benefit Application
We last updated the Senior/Disability Tax Benefit Statement of Income in February 2024, so this is the latest version of Tax Benefit Statement, fully updated for tax year 2023. You can download or print current or past-year PDFs of Tax Benefit Statement directly from TaxFormFinder. You can print other District of Columbia tax forms here.
Other District of Columbia Other Forms:
TaxFormFinder has an additional nineteen District of Columbia income tax forms that you may need, plus all federal income tax forms.
| Form Code | Form Name |
|---|---|
| Form FP-7/CA | Real Property Recordation and Transfer Tax Affidavit Addendum |
| Form FP-7/C | ROD-1 Real Property Recordation and Transfer Tax |
| Form ASD-100 | Homestead Deduction, Senior Citizen and Disabled Property Tax Relief Application |
| Form ASD-105 | Cancellation of Homestead Deduction - Senior Citizen/Disabled Tax Relief |
| Form ROD 16 | Notice of Mechanic's Lien |
View all 20 District of Columbia Income Tax Forms
Form Sources:
District of Columbia usually releases forms for the current tax year between January and April. We last updated District of Columbia Tax Benefit Statement from the Office of Taxpayer Revenue in February 2024.
Historical Past-Year Versions of District of Columbia Tax Benefit Statement
We have a total of three past-year versions of Tax Benefit Statement in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
2023 Tax Benefit Statement
Microsoft Word - CANCELLATIONOFHOMESTEADDEDUCTION Nov 14 edits(clean) (2).docx
2021 Tax Benefit Statement
Microsoft Word - CANCELLATIONOFHOMESTEADDEDUCTION Nov 14 edits(clean) (2).docx
2020 Tax Benefit Statement
Microsoft Word - CANCELLATIONOFHOMESTEADDEDUCTION Nov 14 edits(clean) (2).docx
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