2021 NJ-1040-HW
                                                                                          State of New Jersey
                                                                               Property Tax Credit Application
                                                                        Wounded Warrior Caregivers Credit Application
         Your Social Security Number (required)             Last Name, First Name, Initial (Joint Filers enter first name and middle initial of each. Enter  
                                                                                              spouse’s/CU partner’s last name ONLY if different.)
                   -          -
         
         Spouse’s/CU Partner’s SSN (if filing jointly)      Home Address (Number and Street, including apartment number)
                   -          -
         
         County/Municipality Code (See Table page 50)       City, Town, Post Office                                State            ZIP Code

   1.           Single                                                         Fill in     if your address has changed
   2.           Married/CU Couple, filing joint return
                                                                                                                                         
   3.           Married/CU Partner, filing separate return  NJ RESIDENCY STATUS                              From: M M    /     D D     /12                     
                                                            6.    Part-year residents, provide months/days 
   4.           Head of Household                                 you were a New Jersey resident during 2021:
                                                                                                                                         
                                                                                                             To:   M M    /     D D     /2 1                   
   5            Qualifying Widow(er)/Surviving CU Partner

 Do Not File This Application If: 
 • You file a 2021 New Jersey resident return, Form NJ-1040; or 
 • Your income is more than $20,000, excluding Social Security income ($10,000 if filing status is single or 
   married/CU partner, filing separate return). You must file Form NJ-1040. 

 You can use Form NJ-1040-HW even if you are eligible for only ONE of the credits. 
 If you are applying for the Property Tax Credit, complete Part I. If you are applying for the Wounded Warrior 
 Caregivers Credit, complete Part II. If you are applying for both credits, complete both Parts I and II.

 Part I — Property Tax Credit
 7.      Indicate whether at any time during 2021 you either owned a home or rented a dwelling in New Jersey as your  
         principal residence (main home) on which property taxes (or rent) were paid. Fill in the appropriate oval. If you  
         were both a homeowner and a tenant during the year, fill in “Both.”

               Homeowner                                 Tenant                  Both                          None      (Fill in only one)

         If “Homeowner” or “Tenant” or “Both,” you may be asked to provide proof of property taxes or rent paid on your                                       
         main home. If “None,” you are not eligible for a Property Tax Credit. 

 8a.  On December 31, 2021, were you age 65 or older?                               Yourself                         Yes                  No
                                                                                    Spouse/CU Partner                Yes                  No

 8b.  On December 31, 2021, were you blind or disabled?                             Yourself                         Yes                  No
                                                                                    Spouse/CU Partner                Yes                  No
         If you (and your spouse/CU partner) answered “No,” to all the questions at lines 8a and 8b, you are not eligible  
         for the Property Tax Credit. 

 9.      On October 1, 2021, did you own and occupy a home in New Jersey as 
         your main home?                                                                                     Yes                      No
         If “Yes,” see instructions. 

   Division  1     2                            3                            4      5     6                        7
         use                                                                                    

                                                                                                          Your Social Security Number

                                                                     Name(s) as shown on Form NJ-1040-HW
 Page 2

Part II — Wounded Warrior Caregivers Credit
10.       Did you provide care for a relative who was a qualifying armed services  
          member (see instructions)?                                                                                      Yes             No
          If “Yes,” enter the name and Social Security number of the qualifying service member.

                                                                                   -                     -
                                                                       
          Last Name, First Name, Middle Initial
          Enter your relationship to the qualifying service member.

          You may be asked to provide proof to substantiate your claim.

          If “No,” you are not eligible for a Wounded Warrior Caregivers Credit. Do not complete Part II.

11a.  Enter the 2021 federal disability compensation
          of the armed services member .........................
 
                                                                      675
11b.  Maximum credit allowed ...................................

11c.  Enter the lesser of line 11a or line 11b .................................................................11c.          .

12.   Were you the only caregiver for this service member during the tax year?                                            Yes             No

          If “No,” enter your share (percentage) of the total care expenses for the year                                      %

13.       If you answered “Yes” at line 12, enter the amount from line 11c.

          If you answered “No” at line 12, multiply the amount from  
          line 11c          x                   % from line 12.   ..................................................13.       .

Signature
Under penalties of perjury, I declare that I have examined this application, including accompanying schedules and statements, and to the 
best of my knowledge and belief, it is true, correct, and complete. If prepared by a person other than the taxpayer, this declaration is based 
on all information of which the preparer has any knowledge. 

Your Signature                                                  Date  Spouse’s/CU Partner’s Signature (required if filing jointly)          Date  
  Fill in      if death certificate is enclosed.                      Fill in    if you do not want a paper form next year.
       I authorize the Division of Taxation to discuss my return and enclosures with my preparer (below).
Paid Preparer’s Signature                                       Federal Identification Number                                 Mail your NJ-1040-HW to:
                                                                                                                              NJ Division of Taxation
                                                                                                                              Revenue Processing Center
Firm’s Name                                                     Federal Employer Identification Number                        PO Box 555
                                                                                                                              Trenton, NJ 08647-0555