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                                                                                                                           Department Use Only
                                                          Form                                                             (MM/DD/YY)
                                                               Assessor Certification
                      948
                                                                        Attach this form to the Property Tax Credit Claim (Form MO-PTC), Property Tax Credit (Form MO-PTS), or 
                                                                        the Public Safety Officer Surviving Spouse Credit (Form MO-SSC).
Social Security Number                                                                                         Spouse’s Social Security Number

                                                               -                 -                                                   -                                                          -
Taxpayer Name                                                                                                  Spouse’s Name

Address                                                                                            City                                                                                               State    ZIP Code

                                                                                                         Claimant
                                             If your real estate tax receipt on your homestead includes tax on your dwelling and surrounding land                                                              Tax Year
                                             which exceeds five (5) acres, the county assessor must complete this section to determine the 
                                             appropriate percentage you may claim on Form MO-PTC,Form MO-PTS               , orForm MO-SSC.

                                                                                                   Assessor

                                             1.  Enter assessed valuation of dwelling .  .  .  . .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 
                                             2.  Enter assessed valuation of surrounding land up to five (5) acres used for homestead
                                                          purposes.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  

                      Homestead Taxes        3.  Total valuation of homestead (Add Lines 1 and 2)  .  .  .  . .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 
                                             4.  Enter total assessed valuation on the single tax receipt or single assessment on a tax receipt  .  .  .  . .  .  .  .  .  .  . 

                                             5.  Compute percentage of tax allocated to the homestead (Divide Line 3 by Line 4) (Round to a whole percent.) .  .  .                                                    %
                                             6.  Multiply the Total Tax Paid by the percentage on Line 5. Enter the amount here and on Form MO-PTC, Line 9; 
                                                          Form MO-PTS, Line 11; or Form MO-SSC .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

                                                                                                         Claimant
                                             If you own a mobile home and the tax is shown on your personal property tax receipt, the county assessor must complete this 
                                             section to determine the appropriate percentage you may claim on Form MO-PTC,Form MO-PTS                                                            , or Form MO-SSC.  
                                                                                                   Assessor

                                             1.  Valuation of mobile home only...................................................................
                                             2.  Total valuation of all personal property ............................................................
                                             3.  Compute percentage of personal property tax allocated to the mobile home (Divide Line 1 by Line 2)
                      Mobile Home Percentage              (Round to a whole percent.) ....................................................................                                                             %
                                             4.  Multiply the Total Tax Paid by the percentage on Line 3. Enter the amount here and on Form MO-PTC, Line 9; 
                                                          Form MO-PTS, Line 11; or Form MO- SSC  .......................................................
                                                          Assessor’s Name                                      Telephone Number

                                                          Assessor’s Signature                                 Date (MM/DD/YY)
           Assessor’s                        Certification

                                                                                                                                                                                                               Form 948  (Revised 11-2020)
Mail to:                                                       Taxation Division             Phone:(573) 751-3505                                                                               *15318010001* 
                                                               P.O. Box 2200                 Fax: (573) 522-1762                                                                                   15318010001
                                                               Jefferson City, MO 65105-2200 E-mail for MO-SCC: income@dor.mo.gov 
                                                                                             E-mail for MO-PTC or MO-PTS: propertytaxcredit@dor.mo.gov