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4                                State of Rhode Island Division of Taxation                                                                                                                                                                                                                        4
5                                2024 Form RI-1040H                                                                                                                                                                                                                                                5
6                                Rhode Island Property Tax Relief Claim                                                                      24100299990101                                                                                                                                        6
7                                                                                                                                                                                                                                                                                                  7
8                                                                                                                                                                                                                                                                                                  8
9   First nameYour first name                                MI       Last name MI     Last name                                  Suffix     Deceased?Deceased?Deceased?                                     Y YYour social security numberour social security numberour social security number    9
10 XXXXXXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXXXXX                                                                                    XX             YessYe                                                      999999999                                                                             10
11  Spouse’s first name                                       MI     Last name                                                    Suffix     Deceased?Deceased?                                              Spouse’Spouse’s social security numbers social security number                        11
12 XXXXXXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXXXXX                                                                                    XX             YessYe                                                      999999999                                                                             12
13  MailingMailing addressaddress                                                                                                            NewNew address?address? DaytimeDaytimetelephonetelephonenumbernumber                                                                                  13
14 XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXX                                                                                               YeYess                                                      (999) 999-9999                                                                        14
15  CityCity, town or post office, town or post office                                                                            StateState ZIP codeZIP codeZIP code                                        CityCityCity ororor towntowntown ofofof legallegallegal residenceresidenceresidence   15
16 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                         XX   99999                                                           XXXXXXXXXXXXXXXX 16
17  HomeHomeHomeHome Address if using a PO Box or if your Mailing Address is different from Home AddressAddressEmailEmailEmailEmailif usingaddressaddressaddressaddressa PO Box or if your Mailing Address is different17from Home AddressAddress if using a PO Box or if your Mailing Address is different from Home AddressAddress if using a PO Box or if your Mailing Address is different from Home Address
18 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                              XXXXXXXXXXXXXXXXXXXXXXXX 18
19                                                                                                                                                                                                                                                                                                 19
20 PART 1ELIGIBILITY.  IF YOU ANSWER NO TO ANY OF THESE QUESTIONS, YOU ARE NOT ELIGIBLE FOR THIS CREDIT.                                                                                                                                                                                           20
                                     STOP HERE.              DO NOT COMPLETE THE REST OF THIS FORM.
21                                                                                                                                                                                                                                                                                                 21
22                               A  Were you domiciled in Rhode Island for all of 2024?..................................................................................                                                 A      YES                                                            NO 22
23                                                                                                                                                                                                                                                                                                 23
24                               B  In 2024 did you live in a household or rent a dwelling that was subject to property tax?............................                                                                  B      YES                                                            NO 24
25                                                                                                                                                                                                                                                                                                 25
26                               C  Are you current for property taxes or rent due on the homestead for 2024 and all prior years?.................                                                                        C      YES                                                            NO 26
27                                                                                                                                                                                                                                                                                                 27
                                 D  Were you or your spouse 65 years of age or older and/or disabled as of December 31, 2024?................                                                                             D
28            ELIGIBILITY                                                                                                                                                                                                        YES                                                            NO 28
29                                                                                                                                                                                                                                                                                                 29
30                               E  Was your 2024 total household income from page 2, line 32 $39,275 or less?..........................................                                                                  E      YES                                                            NO 30
31                                                                                                                                                                                                                                                                                                 31
32 PART 2 ADDITIONAL INFORMATION - ATTACH A COPY OF YOUR 2024 SOCIAL SECURITY AWARD LETTER OR FORM 1099 TO 1040H FORM32
33                               1a Enter the total amount of public assistance received by all members of your household...........................                                                                      1a     999999999 99                                                      33
34                                b Enter your total household income from page 2, line 32.............................................................................                                                   1b     999999999 99                                                      34
35                                                                                                                                                                                                                                                                                                 35
36                                c Enter your date of birth ............................            07/13/1955/    /                        1d  Enter spouse's date of birth .....................                                               07/13/1955/    /              36
37                                                                                                                                                                                                                                                                                                 37
38            INFO                e Were you or your spouse disabled and receiving Social Security Disability payments during 2024?                                                                                       1e     YES                                                            NO 38
39                                                                                                                                                                                                                                                                                                 39
40                                f Indicate the number of persons in your household .....................................................................................                                                1f     999999999999                                                      40
41                                g Enter the number of persons from 1f who are dependents under the age of 18........................................                                                                    1g     999999999999                                                      41
42                                                               DRAFT                                                                                                                                                                                                                             42
43 PART 3    TO BE COMPLETED BY HOMEOWNERS ONLY– ATTACH A COPY OF YOUR 2024 PROPERTY TAX BILL TO 1040H FORM                                                                                                                                                                                        43
44                               2  Enter the amount of property taxes you paid or will pay for 2024...............................................................                                                       2      999999999 99                                                      44
45                               3  Using your household income from line 1b enter percentage from the computation table located on pg 3                                                                                  3      0.9999                              %                             45
46                               4  Multiply amount on line 1b by percentage on line 3....................................................................................                                                4      999999999 99                                                      46
47      HOME                     5  Tentative credit.  Subtract line 4 from line 2.  If line 4 is greater than line 2, enter zero..............................                                                           5      999999999 99                                                      47
48                        OWNERS 6  PROPERTY TAX RELIEF. Line 5 or $675.00, whichever is LESS..............................................................                                                               6      999999999 99                                                      48
49                                                                                                                                                                                                                                                                                                 49
50 PART 4 TO BE COMPLETED BY RENTERS ONLY– ATTACH A COPY OF YOUR 2024 LEASE OR 3 RENT RECEIPTS TO 1040H 50
   LANDLORD INFORMATION (REQUIRED) 
51                                                                                                                                                                                                                                                                                                 51
52  Name:                                                                     XXXXXXXXXXXXXXXXXXX Address:                                                                            XXXXXXXXXXXXXXXXXXXXXX Telephone number:999-999-999952
                                 7  Enter the amount of rent you paid in 2024..................................................................................................10/03/20247
53                                                                                                                                                                                                                               999999999 99                                                      53
54                               8  Multiply the amount on line 7 by twenty (20) percent (0.2000)....................................................................                                                     8      999999999 99                                                      54
55                               9  Using your household income from line 1b enter percentage from the computation table located on pg 3                                                                                  9      0.9999                              %                             55
56                               10 Multiply amount on line 1b by percentage on line 9....................................................................................                                                10     999999999 99                                                      56
57                               11 Tentative credit.  Subtract line 10 from line 8.  If line 10 is greater than line 8, enter zero..........................                                                             11     999999999 99                                                      57
              RENTERS            12 PROPERTY TAX RELIEF. Line 11 or $675.00, whichever is LESS............................................................                                                                12
58                                                                                                                                                                                                                               999999999 99                                                      58
59                                                                                                                                                                                                                                                                                                 59
60  CREDIT                       13 PROPERTY TAX RELIEF. Line 6  or line 12, whichever applies. Enter here and on Form RI-1040, line 14c.......                                                                           13     999999999 99                                                      60
61                                                                                                                                                                                                                                                                                                 61
62                                                     RETURN MUST BE SIGNED - SIGNATURE IS LOCATED ON PAGE 2                                                                                                                                                                                      62
                          1111111111222222222233333333334444444444555555555566666666667777777777888Mailing address: RI Division of Taxation, One Capitol Hill, Providence, RI 02908-5806
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4                                   State of Rhode Island Division of Taxation                                                                                                                                                             4
5                                   2024 Form RI-1040H                                                                                                                                                                                     5
6                                   Rhode Island Property Tax Relief Claim                                                                              24100299990102                                                                     6
7                                                                                                                                                                                                                                          7
8                                                                                                                                                                                                                                          8
    YYour nameour name                                                                                                                                                         YourYsocial security numberour social security number
9                                                                                                                                                                                                                                          9
10  XXXXXXXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXXXXXXX                                                                                                 999999999                                            10
11 PART 5  ENTER ALL INCOME RECEIVED BY YOU AND ALL OTHER PERSONS LIVING IN YOUR HOUSEHOLD                                                                                                                                          11
   Enter the income amounts from your 2024 federal 1040 on the appropriate lines below.  If you did not file a federal 1040, enter your income amounts on 
12 the appropriate lines below.                                                                                                                                                                                                     12
13                                                                                                                                                                                                                                  13
14                                  14 Wages, salaries, tips, etc. from Federal Form 1040 or 1040-SR, line 1z...........................................................                                    14 999999999 99         14
15                                                                                                                                                                                                                                  15
                                    15 Interest and dividends (taxable and nontaxable) from Federal Form 1040 or 1040-SR, lines 2a, 2b and 3b.........                                                      15
16                                                                                                                                                                                                             999999999 99         16
17                                  16 Taxable refunds, credits or offsets of state and local income taxes from Federal Form 1040 or 1040-SR,                                                               16                      17
18                                     Sch 1, line 1.......................................................................................................................................................    999999999 99         18
19                                                                                                                                                                                                                                  19
20                                  17 Alimony received from Federal Form 1040 or 1040-SR, Schedule 1, line 2a..............................................                                                17 999999999 99         20
21                                                                                                                                                                                                                                  21
22                                  18 Business income (or loss) from Federal Form 1040 or 1040-SR, Schedule 1, line 3..................................                                                    18 999999999 99         22
23                                  19 Sale or exchange of property from Federal Form 1040 or 1040-SR line 7 or Federal Form 1040 or 1040-                                                                  19                      23
24                                     SR Schedule 1, line 4..................................................................................................................................                 999999999 99         24
25                                  20 IRA distributions, and pensions and annuities from Federal Form 1040 or 1040-SR, line 4a and 5a.  If                                                                 20                      25
26                                     your pension and/or annuity is fully taxable, use the amount from Federal Form 1040 or 1040-SR, line 5b                                                                 999999999 99         26
27                                                                                                                                                                                                                                  27
                                    21 Rental real estate, royalties, S corps, trusts, etc. from Federal Form 1040 or 1040-SR, Sch 1, line 5........                                                        21
28                                                                                                                                                                                                             999999999 99         28
29                                                                                                                                                                                                                                  29
                                    22 Farm income or loss from Federal Form 1040 or 1040-SR, Schedule 1, line 6..........................................                                                  22
30                                                                                                                                                                                                             999999999 99         30
31                                                                                                                                                                                                                                  31
32                                  23 Unemployment compensation from Federal Form 1040 or 1040-SR, Schedule 1, line 7...............................                                                       23 999999999 99         32
33                                  24 Social security benefits (including Medicare premiums) taxable and nontaxable, and Railroad                                                                          24                      33
34                                     Retirement Benefits from Federal Form 1040 or 1040-SR, line 6a.............................................................                                             999999999 99         34
35                                                                                                                                                                                                                                  35
                                    25 Other income from Federal Form 1040 or 1040-SR, Schedule 1, line 9.....................................................                                              25
36                                                                                                                                                                                                             999999999 99         36
37                                                                                                                                                                                                                                  37
                                    26 Total income from Federal 1040 or 1040-SR- taxable and nontaxable.  Add lines 14 through 25....................                                                      26
38                                                                                                                                                                                                             999999999 99         38
39                                                                                                                                                                                                                                  39
                                    27 Deductions from Federal Form 1040 or 1040-SR, line 10..................................................................................                              27
40                                                                                                                                                                                                             999999999 99         40
41       HOUSEHOLD INCOME WORKSHEET                                                                                                                                                                                                 41
                                    28 Adjusted income.  Subtract line 27 from line 26..........................................................................................                            28
42                                                        DRAFT                                                                                                                                                999999999 99         42
43                                                                                                                                                                                                                                  43
                                    29 Cash public assistance received.  Enter here and on page 1, Part 2, line 1a.............................................                                             29
44                                                                                                                                                                                                             999999999 99         44
45                                                                                                                                                                                                                                  45
                                    30 Other non-taxable income including child support, worker’s compensation and monetary gifts.................                                                          30
46                                                                                                                                                                                                             999999999 99         46
47                                                                                                                                                                                                                                  47
                                    31 Addback of rental losses, etc. from lines 18, 19, 21, 22 or 25 above..........................................................                                       31
48                                                                                                                                                                                                             999999999 99         48
49                                                                                                                                                                                                                                  49
50                                  32 TOTAL 2024 HOUSEHOLD INCOME.  Add lines 28, 29, 30 and 31.  Enter here and on page 1, line 1b.......                                                                 32 999999999 99         50
51                                                                                                                                                                                                                                  51
                                    33 Bank Account Withdrawals (see instructions)..............................................................................................                            33
52                                                                                                                                                                                                                                  52
                                                                  10/03/2024999999999 99
53  Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and                                                                           53
54  belief, it is true, accurate and complete.  Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.                                                                      54
55  Your signature                                                      Spouse’s signature                                                                                Date                                     Telephone number 55
56                                                                                                                                                      09/28/2020                                          (999) 999-9999 56
57  Paid preparer signature                                          Print name                                                                                           Date                                     Telephone number 57
58                                                                                                                                                                                                                                  58
    Paid preparer address                                 XXXXXXXXXXXXXXXXXXXXX    City, town or post office         State                              09/28/2020  ZIP code                                (999)  PTIN999-9999
59                                                                                                                                                                                                                                  59
60 XXXXXXXXXXXXXXXXXXX                                    XXXXXXXXXXXXXXXXX                                                                          XX 99999                                               P999999999              60
61                                                                                                                                                                                                                                  61
62                                                        May the Division of Taxation contact your preparer?   YES                                                                                                                 62
                                    1111111111222222222233333333334444444444555555555566666666667777777777888
34567890123456789012345678901234567890123456789012345678901234567890123456789012Revised 
                                                                                                                                                                                                                                    09/2024

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34567890123456789012345678901234567890123456789012345678901234567890123456789012State of Rhode Island Division of Taxation 
 4                    2024 Form RI-1040H                                                                                                                                            4
 5                    Rhode Island Property Tax Relief Claim                                                                                                                        5
 6                                                                                                                                                                                  6
 7                                                                                                                                                                                  7
                                                                         GENERAL INSTRUCTIONS
 8                                                                                                                                                                                  8
WHEN9      AND WHERE TO FILE                                                                   IMPORTANT DEFINITIONS                                                                9
10Form RI-1040H must be filed by April 15, 2025.                                               What is meant“bankbyaccount withdrawals”             - The term “bank account withdrawals”10
Even if you are seeking a filing extension for your Rhode Island income tax return, RI-           means withdrawals made by any persons of a household from a bank account to 
111040, Form RI-1040Hmust be filed by April 15, 2025.  An extension of time to file               pay rent, property taxes or other personal expenses for the year. Report this11amount 
12Form RI-1040,NOTdoes  extend the time to file Form RI-1040H.                                    on line 33. This is not classified as additional taxable income, but it is understood12
13                                                                                                that some individuals may use prior deposits to pay current year rent, property13tax 
If filing with Form RI-1040, your property tax relief credit will decrease any income tax         or other personal expenses. As with all reported items on this return, documentation 
14due or increase any income tax refund.                                                          may be requested.                                                               14
15                                                                                                                                                                                15
16If you are not required to file a Rhode Island income tax return, Form RI-1040H may be       What is meant“dependent”by a             - The term “dependent” means any person living16in 
   filed by itself without attaching it to a Rhode Island income tax return.  However, Form       the household who is under the age of 18 who can be claimed by someone else on 
17RI-1040H must be filed by April 15, 2025.                                                       their tax return.                                                               17
18                                                                                                                                                                                18
19Your property tax relief claim should be filed as soon as possible after December 31,        What is meant“disabled”by          - The term "disabled" means you are receiving a social19
   2024.  However, no claim for the year 2024 will be allowed unless such claim is filed          security disability benefit. 
20by     April 15, 2025.  For additional filing instructions, see R.I. Gen. Laws § 44-33.                                                                                         20
21Mail your property tax relief claim to the Rhode Island Division of Taxation - One           What is meant“homestead”by              - The term "homestead" means your Rhode Island21
22Capitol Hill - Providence, RI  02908-5806.                                                      dwelling, whether owned or rented, and so much of the land around it as is reason-22
                                                                                                  ably necessary for the use of the dwelling as a home, but not exceeding one acre.  
23WHO MAY QUALIFY                                                                                 It may consist of a part of a multi-dwelling, a multi-purpose building or another23shel-
24To qualify for the property tax relief credit you must meet  allof the following conditions:    ter in which people live.  It may be an apartment, a houseboat, a mobile home24or a 
25a) You must be sixty-five (65) years of age or older and/or disabled.                           farm.                                                                           25
b) You must have been domiciled in Rhode Island for the entire calendar year 2024.              
26c) Your household income must have been $39,275.00 or less.                                  What is meant“household”by a            - The term "household" means one or more persons26
27d) You must have lived in a household or rented a dwelling that was subject to property         occupying a dwelling unit and living as a single nonprofit housekeeping unit. 27House-
28taxes.                                                                                          hold does not mean bona fide lessees, tenants or roomers and borders on contract.28
e) You must be current on property tax and rent payments due on your homestead for              
29all prior years and on any current installments.                                             What is meant“householdby income”           - The term "household income" means all29income 
30                                                                                                received both taxable and nontaxable by all persons of a household in a calendar30
31WHO MAY CLAIM CREDIT                                                                            year while members of the household.                                            31
If you meet all of the qualifications outlined above, you should complete Form RI-1040H         
32to determine if you are entitled to a credit.                                                What is meant“publicbyassistance”           - The term “public assistance” means cash32as-
33                                                                                                sistance from government assistance programs informally known as welfare33assis-
34Only one person of a household may claim the credit.  If there are multiple individuals         tance, and more commonly known as “Temporary Assistance for Needy Families34
within a household, the taxable and non-taxable income of all household members                   (TANF)”.  Under R.I. Gen. Laws § 44-33-16, a claim for property tax relief shall ex-
35must be included in part 5 of this return.  If the household income of all members is           clude all taxes or rent paid with public assistance.                            35
36less than or equal to the $39,275.00 threshold, the credit may still be claimed, but only                                                                                       36
37by one member of the household.                                                                 Note:  Part 5, line 29 and Part 2, line 1a must be equal.                       37
                                                                                                
38The right to file a claim does not survive a person's death; therefore a claim filed on      What is meantrent paidby "for occupancy only           " - The term "rent paid for occupancy38
39behalf of a deceased person cannot be allowed.  If the claimant dies after having filed         only" means the gross rent paid only for the right of occupying your homestead. 39If 
40a timely claim, the amount thereof will be disbursed to another member of the house-            you rented furnished quarters, or if utilities were furnished, such as heat, electricity,40
hold as determined by the Tax Administrator.                                                      etc., then you must reduce the amount of gross rent by the reasonable rental value 
41                                                                                                (not cost) of the furniture and the reasonable value of such utilities as were fur-41
42                                                                  DRAFTnished.                                                                                                  42
43ATTACHMENTS - Keep your originals - send in copies                                                                                                                              43
44Attached to this claim shall be:                                                             LIMITATIONS ON CREDIT                                                              44
For homeowners: A copy of your 2024 property tax bill.                                         Under the provisions of R.I. Gen. Laws § 44-33-16, a claim for relief shall exclude all 
45For renters: Copies of three (3) rent receipts for the year 2024, or a copy of your 2024     taxes or rent paid with public assistance funds.  The maximum amount of credit45allow-
46lease agreement. You should keep your original rent receipts and send in photo-              able under Chapter 44-33, Property Tax Relief Act, for calendar year 2024 is $675.00. 46
47copies printed on letter sized (8 1/2” x 11”) paper.                                         In the event that more than one person owns the residence, the taxes will be divided47
If you lived in subsidized housing, attach a copy of your HUD statement.                       by the owner's share. 
48                                                                                                                                                                                48
49If you are a claimant under age 65, you MUST attach a copy of your social secu-                                                                                                 49
rity disability award letter or Form 1099-SSA for the year 2024.                               RENTED LAND 
50                                                                                             If you live on land that is rented and your home or trailer is subject to property tax.50Mul-
51                                                                                             tiply the amount of rent you paid in 2024 by 20% and add the amount to the property51
                                                                                               tax paid.  Then enter the total on RI-1040H, line 2. 
52                                                                                                                                                                                52
                                                                         10/03/2024                        Example: 
53                                                                                                                                                                                53
54                                                                                                         Rent ($3,600 X 20%)........................   ___________              54
55                                                                                                                                                                                55
56                                                                                                         Property Tax......................................   ___________       56
57                                                                                                                                                                                57
                                                                                                           Amount to be entered on line 2.........   ___________
58                                                                                                                                                                                58
59     COMPUTATION TABLE INSTRUCTIONS                                                                                        Household                    Percentage of income    59
60     Step 1         Read down the column titled household income until you find the income range                           income                       allowable as credit     60
61                    that includes the amount shown on line 32.                                                                                          1 person   2 or more    61
                                                                                                                             Less than 6,741              3%                3% 
62     Step 2         Read across from the income range line determined in step 1 to find the percent                        6,741 -  10,105              4%                4%    62
                 1111111111222222222233333333334444444444555555555566666666667777777777888of income allowed as a credit.  Enter this percentage on line 3 or line 9,   10,106 - 13,470 5% 5% 
34567890123456789012345678901234567890123456789012345678901234567890123456789012whichever applies.                           13,471 - 16,835              6%                5% 
                                                                                                                             16,836 - 39,275              6%                6%