Eddie Cook 
         Maricopa County Assessor 

                             2022 SENIOR VALUATION PROTECTION “SENIOR FREEZE” APPLICATION 

                                       PLEASE CHECK ONE: 
                             NEW APPLICATION        ⃣ RENEWAL APPLICATION    ⃣
         Please read the instructions on the reverse side before completing this form. 
                        This form must be submitted on or beforeSeptember 1st. 

Parcel OR Account Number ________ - _____ - _______ (http://www.mcassessor.maricopa.gov)

Owner Name(s)_________________________________&______________________________________ 

Primary Residence Address: __________________________________City______________Zip________ 

Mailing Address: ___________________________________________City______________ Zip________ 

Phone: _________________________E-Mail ________________________________________________ 

Alt Phone or E-Mail__________________________________________Self ____ Spouse____ Other____ 
           PLEASE ANSWER ALL STATEMENTS AND QUESTIONS BELOW (CHECK): 
I have lived in the primary residence a minimum of two years or more.  Yes ____ No ___ 
One of the owners is at least 65 years of age in the home. Yes ____ No ____ 
I filed federal tax returns in (Check all applicable years) 2021 ____ 2020 ____ 2019____Non -filer_____ 
Reason for non -filing: __________________________________________________________________ 
     I HAVE PROVIDED THE FOLLOWING DOCUMENTS WITH MY APPLICATION (CHECK): 
COPY: First two pages of the owner(s) federal tax return for the past 3 years provided Yes____ No____ 
COPY: Proof of age provided (Birth certificate, driver’s license, or passport) Yes ____ No ____ 
COPY: Proof of residency provided (Driver’ s license, state ID or voter card) Yes ____ No _____ 
INCOME INFORMATION:  List total annual income for all owners from all sources, taxable and non-
taxable, for the previous three calendar years.  Documentation may be requested by the Assessor to 
verify income. 

INCOME FROM ALL SOURCES                      Year One (2021)         Year Two (2020)    Year Three (2019) 
Salaries, wages, and tips earned.            $                       $                  $ 
                                             +                    +                     + 
Social Security benefits received. 
                                             +                    +                     + 
Pension and annuity income received. 
*ALL OTHER INCOME earned or received.           +                 +                     + 

TOTAL ANNUAL COMBINED INCOME =               =$                      =$                 =$ 
*Please explain “ALL OTHER INCOME”: ____________________________________________________
I confirm that my income from all sources does not exceed $40,368       for one owner OR does not 
exceed $50,460    for two or more owners, averaged over the past 3 years. Yes ____ No ____  
Under penalty of perjury, I/we hereby certify that all the information contained in this application form 
and supporting documentation is true and correct. I/we consent to the freezing of the value of our 
primary residence for a three-year period. 

Print Name (s)__________________________ /_______________________ Date__________ 

Signatures (s)__________________________ /________________________ Date__________ 
VRPSVP IE 1346 09032021                          301 W Jefferson Street Phoenix, AZ 85003 www.mcassessor.maricopa.gov 

          Eddie Cook 
          Maricopa County Assessor 

                            2022 SENIOR VALUATION PROTECTION “SENIOR FREEZE” APPLICATION 

          SENIOR PROPERTY VALUATION PROTECTION “               SENIOR FREEZE” OPTION 
                                          INSTRUCTIONS 
Arizona voters approved Proposition 104 in the November 2000 General Election, and Proposition 102 in 
the November 2002 General Election, thereby amending the  Arizona  Constitution.  The  Amendments 
provide  for  the “freezing”  of  the valuation of the primary residence of those seniors who meet all 
the following requirements: 
1. At least one of the owners must be sixty-five years of age at the time the application is
   filed. A copy of proof of age must be submitted.
2. The property must be the primary residence of the taxpayer. For purposes  of this
   application “Primary residence” as defined in Article 9 Section 18 of the Arizona Constitution
   means all owner-occupied real property and improvements to that real property in this state
   that is a single-family home, condominium or townhouse or an owner-occupied mobile home
   that is used for residential purposes.
3. The owner must have resided in the primary residence for at least two years prior to
   applying for the option.
4. The owner(s) total income from all sources, including nontaxable income, cannot
   exceed the amount specified by law.
For an initial valuation protection option application, if the owner meets all these requirements and the 
County Assessor approves the application, the valuation of the primary residence will remain fixed for a 
three-year period. 
To remain eligible, the owner is required to renew the valuation protection option during  the  last  six 
months  of  the  three-year period on receipt  of  a  notice  of reapplication from the County Assessor. 
The freeze terminates if the owner sells the home or otherwise becomes ineligible. The property’s 
valuation will revert to its current full cash value and limited property value as determined by the County 
Assessor in the valuation year in which the sale is completed. 
Please  be aware  that,  while  the  VALUATION will  be frozen  for  as long  as the owner remains 
eligible, TAXES for the primary residence will NOT be frozen and will continue to be levied at
the same rate that is applicable to all other properties in the taxing district. 
                                          REMINDERS: 
1. To protect your identity, please block out all social security and/or account numbers on your
   document copies.
2. Never send original documents.
3. Return your completed application with supporting documents to:
          a. Our general inbox at PE.SVP@Maricopa.gov. You will receive a receipt confirmation email
          within 24-48 hours. OR…
          b. Return your completed application with supporting documents via USPS to:
                                 Maricopa County Assessor: Attn SVP 
                                 301 W Jefferson St Phoenix, AZ 85003 
                                                OR …
          c. Return your completed application with supporting documents via fax: Attn SVP at 602- 
          506-7620
   Questions?Contact any team member          atPE.SVP@Maricopa.gov OR call 602-506-3591. 
VRPSVP IE 1346 09032021                        301 W Jefferson Street Phoenix, AZ 85003 www.mcassessor.maricopa.gov