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2021 Iowa Mobile/Manufactured/Modular Home Owner Application for Reduced Tax Rate, page 2
Instructions
Who is Eligible? taxable dividends and distributions received.
• Total 2020 household income was less than Include cash dividends and dividends paid in the
$24,206 and form of merchandise or other property and report at
• Age 23 or older as of December 31, 2020. fair market value.
Household income includes your income and your Line 8: Profit from business and/or farming and
spouse’s income, if living together, and monetary capital gain - Enter profit from business and/or
contributions received from other persons living farming, and any gain received from the sale or
with you. If you and your spouse are not living exchange of capital assets. Capital losses are
together, file separate claims. limited to the same amount that you are allowed to
report for income tax purposes. Any loss must be
Line 1: Wages, salaries, unemployment
offset against gain, and a net loss must be reported
compensation, tips, etc. - Enter the total wages,
as zero.
salaries, unemployment compensation, tips,
bonuses, and commissions received. If you are Line 9: Money received from others living with you
living with your spouse, include the total amounts - Enter money received from others living with you.
received by both you and your spouse. Do not include goods and services received.
Line 2: In-kind assistance - Enter any portion of Line 10: Other income - Enter total income
your housing expenses, including utilities, that were received from the following sources:
paid for you. Do not enter Federal Energy • Child support and alimony payments.
Assistance. • Welfare payments. Report Family Investment
Line 3: Title 19 benefits - Enter your Title 19 Program (FIP), children’s Supplemental Security
benefits received for housing expenses. Do not Income (SSI), and all other welfare program cash
include medical benefits. payments. Do not include foster grandparents’
Line 4: Social Security income - Enter the total stipends or non-cash government assistance
Social Security benefits received, even if not (food, clothing, food stamps, medical supplies,
reportable for income tax purposes. Include any etc.).
Medicare premiums withheld. • Insurance income not reported elsewhere.
• Gambling and all other income not reported
Line 5: Disability income - Enter the total received
elsewhere.
for disability or injury compensation, even if not
reportable for income tax purposes. Additional Information:
The location of your county treasurer can be found
Line 6: All pensions and annuities – Enter the total
at the Iowa County Treasurers website:
received from pensions and annuities. Include
iowatreasurers.org .
retirement pay for military service, even if not
For information about your Social Security benefits,
reportable for income tax purposes.
go to the Social Security Administration website
Line 7: Interest and dividend income - Enter ssa.gov/myaccount.
taxable interest income, plus all interest income
from federal, state, and municipal securities. Enter
For use by County Treasurer only
Reduced Square footage: __________________________________
Income tax rate Year of manufacture: ______________________________
$0.00 – 12,469.99 .00 * If year of manufacture is 2012-2015, apply 90% factor.
12,470.00 – 13,936.99 .03
* If year of manufacture is 2011 or before, apply 80% factor.
13,937.00 – 15,403.99 .06
Regular tax: _____________________________________
15,404.00 – 18,337.99 .10
18,338.00 – 21,271.99 .13 Reduced tax: ____________________________________
21,272.00 – 24,205.99 .15 Reimbursement: _________________________________
54-014b (10/19/2020)
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