Pennsylvania Property Tax or Rent Rebate Claim

Property Tax or Rent Rebate Claim
2023 Property Tax or Rent Rebate Claim (PA-1000)
IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING
2305010056

PA-1000

Property Tax or Rent
Rebate Claim 03-23 (FI)
PA Department of Revenue
P.O. Box 280503
Harrisburg PA 17128-0503

I

START

2023

OFFICIAL USE ONLY

Check your label for accuracy. If incorrect, do not use the label. Complete Section I.

Your Social Security Number

Spouse’s Social Security Number

➜

II Fill in only one oval in each

If Spouse is
Deceased, fill
in the oval.

PLEASE WRITE IN YOUR SOCIAL SECURITY NUMBER(S) ABOVE

Last Name

First Name

MI

First Line of Address

Second Line of Address

City or Post Office

State

Spouse’s First Name

MI

ZIP Code

County Code School District Code

*

*

CODES
*REQUIRED

section.
1. I am filing for a rebate as a:
P. Property Owner – See
instructions
R. Renter – See instructions
B. Owner/Renter – See
instructions
2. I Certify that as of Dec. 31, 2023,
I am (a):
A. Claimant age 65 or older
B. Claimant under age 65,
with a spouse age 65 or
older who resided in the
same household
C. Widow or widower, age
50 to 64
D. Permanently disabled
and age 18 to 64

Country Code
3.
Filing on behalf of a
decedent

Claimant’s Birthdate MM/DD/YY Spouse’s Birthdate MM/DD/YY Daytime Telephone Number

III

Dollars

TOTAL INCOME received by you and your spouse during 2023
divided by 2) . . . . . . . . . .

4.

divided by 2) . . . . . . . . . . .

5.

6. Total Benefits from Pension, Annuity, IRA Distributions and Railroad Retirement Tier 2 (Do not
include federal veterans’ disability payments or state veterans’ payments.) . . . . . . . . . . . . . . . . . . .

6.

7. Interest and Dividend Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7.

4. Social Security, SSI and SSP Income (Total benefits $
5. Railroad Retirement Tier 1 Benefits (Total benefits $

Cents

LOSS

8.

8. Gain or Loss on the Sale or Exchange of Property. . . . . . . . . If a loss, fill in this oval. . . . .
LOSS

9.

9. Net Rental Income or Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . If a loss, fill in this oval. . . . .
LOSS

10.

10. Net Business Income or Loss . . . . . . . . . . . . . . . . . . . . . . . . . If a loss, fill in this oval. . . . .
Other Income.
11a. Salaries, wages, bonuses, commissions, and estate and trust income. . . . . . . . . . . . . . . . . . . . .

11a.

11b. Gambling and Lottery winnings, including PA Lottery winnings, prize winnings and the value
of other prizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11b.

11c. Value of inheritances, alimony and spousal support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11c.

11d. Cash public assistance/relief. Unemployment compensation and workers’ compensation,
except Section 306(c) benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11e. Gross amount of loss of time insurance benefits and disability insurance benefits,
and life insurance benefits, except the first $5,000 of total death benefit payments. . . . . . . . . . . .

11d.
11e.

11f. Gifts of cash or property totaling more than $300, except gifts between
members of a household. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11f.

11g. Miscellaneous income and annualized income amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11g.

12. Claimants with Federal Civil Service Retirement System Benefits enter $9,948 or $19,896.
See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.

13. TOTAL INCOME. Add only the positive income amounts from Lines 4 through 11g and subtract
the amount on Line 12. See Page 3 for income limitations. Enter this amount on Line 23. . . . . . . .

13.

IMPORTANT: You must submit proof of the income you reported – See the instructions on Pages 7 to 9.

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IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING
2305110054

PA-1000 2023 03-23 (FI)
START

Your Social Security Number

➜
Your Name:

PROPERTY OWNERS ONLY

14. Total 2023 property tax. Submit copies of receipted tax bills.

15. Property Tax Rebate. Enter the maximum standard rebate
amount from Table A for your income level here: (_______)

. . . . . . . . . . . . . . . . . . . . . . . . . . . 14.
Compare this amount to line 14 and
enter the lesser amount to the right. 15.

RENTERS ONLY

16. Total 2023 rent paid. Submit PA Rent Certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.
17. Multiply Line 16 by 20 percent (0.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.
18. Rent Rebate. Enter the maximum rebate amount
Compare this amount to line 17 and
from Table B for your income level here: (_______)
enter the lesser amount to the right.
18.

OWNER – RENTER ONLY

19. Property Tax/Rent Rebate. Enter the maximum
rebate amount from Table A for your income
level here: (_______)

Compare this amount to the sum of
Lines 15 and 18 and enter the lesser
amount to the right.

19.

DIRECT DEPOSIT. Banking rules do not permit direct deposits to bank accounts outside the U.S. If your bank account is outside the U.S.,
do not complete the direct deposit Lines 20, 21 and 22. The department will mail you a paper check. If your rebate will be going to a bank
account within the U.S., you have the option to have your rebate directly deposited. If you want the department to directly deposit your rebate
into your checking or savings account, complete Lines 20, 21 and 22.
Checking

20. Place an X in one box to authorize the Department of Revenue to directly deposit your rebate
into your: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.

21. Routing number. Enter in boxes to the right. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Savings

21.

22. Account number. Enter in boxes to the right. . . . . . . . . . 22.

23.
Enter the amount from Line 13 of
the claim form on this line and circle
the corresponding Maximum Rebate
amount for your income level.
Owners use Table A and Renters
use Table B.

TABLE A - OWNERS ONLY
INCOME LEVEL
Maximum Standard
Rebate
$
0 to $ 8,000
$1,000
$ 8,001 to $15,000
$ 770
$15,001 to $18,000
$ 460
$18,001 to $45,000
$ 380

TABLE B - RENTERS ONLY
INCOME LEVEL
Maximum
Rebate
$
0 to $ 8,000
$1,000
$ 8,001 to $15,000
$ 770
$ 15,001 to $18,000
$ 460
$ 18,001 to $45,000
$ 380

IV An excessive claim with intent to defraud is a misdemeanor punishable by a maximum fine of $1,000, and/or imprisonment for up to one year
upon conviction. The claimant is also subject to a penalty of 25 percent of the entire amount claimed.
CLAIMANT OATH: I declare that this claim is true, correct and complete to the best of my knowledge and belief, and this is the only claim filed by
members of my household. I authorize the PA Department of Revenue access to my federal and state Personal Income Tax records, my PACE records, my
Social Security Administration records and/or my Department of Human Services records. This access is for verifying the truth, correctness and
completeness of the information reported in this claim.
Claimant’s Signature

Date
MM/DD/YY

Spouse’s Signature

Date

Please sign the PA-1000 after printing.

1.

Please sign the PA-1000 after printing.

2.

PREPARER: I declare that I prepared this return, and that it is to the best of my
knowledge and belief, true, correct and complete.
MM/DD/YY
Preparer’s Signature, if other than the claimant

Please sign the PA-1000 after printing.

Witnesses’ Signatures: If the claimant cannot sign, but only makes a mark.

Date

Please sign the PA-1000 after printing.

Please sign the PA-1000 after printing.

Name of claimant’s power of attorney or nearest relative. Please print.
Telephone number of claimant’s power of attorney or nearest relative.

Preparer’s Name. Please print.

Home address of claimant’s power of attorney or nearest relative. Please print.

Preparer’s telephone number

City or Post Office

State

ZIP Code

Claim filing deadline – June 30, 2024
You can call 1-888-728-2937 after June 1 to verify the status of your claim.
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