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PTAX343-R Annual Verification of Eligibility for the Homestead Exemption for Persons with Disabilities (HEPD)
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PIN, Tax ID, Property Identification Number
Assessment year for which you are requesting this exemption:
Date of Birth
Date of Birth
Proof of disability
Please upload your proof of disability.
Is this the only property for which you have applied for this exemption?
On January 1, were you the owner of record, or have a legal or equitable interest, or have a life care contract with a facility under the Life Care Facilities Act?
Are you liable for the payment of real estate taxes?
On January 1, did you occupy this property as your primary residence?
On January 1, were you a resident of a facility licensed under the ID/DD (intellectually disabled/developmentally disabled) Community Care Act, Nursing Home Care Act, Specialized Mental Health Rehabilitation Act of 2013, or MC/DD (Medically Complex for the Developmentally Disabled) Act?
enter the name and address of the facility
was this property occupied by your spouse or did it remain unoccupied?
Select the statement to identify the proof of disability that qualifies you for the HEPD
-- Select One --
Valid Class 2 or 2A Illinois Disabled Person Identification Card issued from the Illinois Secretary of State.
Social Security Administration (SSA) disability benefits.
Veterans Administration (VA) pension for a non-service connected disability.
Railroad or Civil Service disability benefits for total (100%) disability.
Form PTAX-343-A, Physician’s Statement for the Homestead Exemption for Persons with Disabilities.
Select the statement that identifies the document you submitted the first time you signed up for this exemption.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I state under penalties of perjury that to the best of my knowledge, the information contained in this application is true, correct, and complete.
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