- 2 -
|
Senior Citizen Tax Freeze (SCTX) Application
3 Annual Income
Please use the worksheet below and enter your annual income. Please include a copy of the proof of income
from the first year of your eligibility. To qualify for 2022 and later, your total income must be $33,500 or less
for a single person or $41,500 or less for a married couple. To qualify for years before 2022, your total
income must have been $27,500 or less for a single person or $35,500 or less for a married couple.
TOTAL Examples of proof of income
INCOME SOURCE
(APPLICANT + SPOUSE) · Social Security (SSA, SSDI,
Social Security Benefits (include SSI, SSD, etc.) SSI) award letters
Do not include any Medicare Part B premiums · Pension statements
· Bank Statements
Pensions and other retirement benefits
Include railroad benefits, taxable portion of IRAs etc. · Retirement income or
Rental Income Statements
Take home pay · Interest and dividends
Include salary, wages, self employment income etc.-
· Pay stubs from your current
Interests, dividends, and capital gains prizes employer
Do not subtract losses · W 2 or state/federal tax-
Net rental and business income return Salary and wages of-
Do not subtract losses Taxpayer and Spouse
· Unemployment/Workers
Other income compensation statements
Include unemployment compensation, support money etc. or award letters
TOTAL · Child support and alimony
· Any other documentation
you may have
Along with proof of income, you must send a · Drivers license
photocopy of your proof of age with this application. · State ID card
Any government issued document that clearly shows a · City of Philadelphia ID card
date of birth will be accepted. Some examples are: · Birth certificate
4 Signature
The Department of Revenue will use this application to enroll you in the Homestead Exemption program
if you do not already have it. The Homestead Exemption can save you money on your property taxes.
The Department of Revenue is authorized to perform an income verification check with the Internal
Revenue Service and Pennsylvania Department of Revenue. If at any time during the program the city
determines you were income ineligible, you will be required to pay the taxes which would have been due,
plus penalties, interest, and additions.
(optional) The City makes its best efforts to contact SCTX applicants and participants through all
methods possible. By checking this box, I authorize the Department of Revenue to use SMS (text)
messages to reach me.
I have reviewed all the information on this form and I certify that this information is true and correct to
the best of my knowledge, information and belief.
Applicant Signature Spouse Signature
Date Phone Number
Mail completed forms to: or return in person:
Philadelphia Department of Revenue Municipal Services Building Northeast Municipal Services Center
P.O. Box 53190 Department of Revenue 7522 Castor Ave.
Philadelphia, PA 19105 1401 John F. Kennedy Blvd— Philadelphia PA 19152,
Concourse level
Philadelphia, PA 19102
Ver 20220927 www.phila.gov/senior freeze | revenue@phila.gov | (215) 686 6442- - Page 2 of 2
|