VT. DEPT.

OF TAXES, Montpelier, Vermont 05609-1401 / (802) 828-2865

2000 VT

Act 60 Property Tax Calculation

HS-133
Claimants Date of Birth Month Day

FORM

Claimants with less than $75,000 Household Income DUE DATE: April 17, 2001 For the year Jan. 1Dec. 31, 2000 PRINT in BLUE or BLACK INK Must Be Filed With: Property Tax Bill and Form HI -144 May Also Require: Form LC-142
Q1. Were you claimed as a dependent in 2000 by another taxpayer?

s NO, Go to Q2 & Q3 s YES, STOP You are not eligible. If a 2000 prebate received, GO TO Repayment Voucher on page 57. See definition Q2. Were you domiciled (legal resident) in Vermont all of calendar year 2000? s Yes s No of homestead, page 58. Q3. Did you own your Vermont homestead on December 31, 2000? s Yes s No
NO answer to either Q2 or Q3, STOP. You are not eligible. If a 2000 prebate received, GO TO Repayment Voucher on page 57. YES answer to Q2 and Q3, complete this form.
Claimants Last Name Spouses Last Name Mailing Address (Number and Street, including Rural Route) City, Town, or Post Office State Zip Code First Name First Name Initial Initial Check here if name or address has changed Vermont School Code

Year

Claimants Social Security Number

Spouses Social Security Number

City/Town of Legal Residence on 12/31/2000

Location of Homestead Daytime phone number

State

s Claimant s Spouse
Homestead School Property Taxes (from property tax bill) Homestead Municipal Property Tax (from property tax bill) Household Income 2000 Prebate

number, street / road name

CHECK HERE to have Department calculate benefit for you. Complete Form HI-144 first and then enter information in the applicable boxes. Homestead Value (from property tax bill) IF $47,000 OR LESS HOUSEHOLD INCOME: (from Form LC-142) File Form LC-142 with this form. GO TO BACK OF FORM. Signature required. Check box if you want a 2001 prebate. Then file this form with your HI-144, a copy of your property tax bill, and LC-142 if applicable.

(from Form HI-144, Line t) (from 2000 Prebate Notice) Mobile Home Lot Rent (if applicable)

TO DO YOUR OWN PROPERTY TAX CALCULATION, COMPLETE THE FOLLOWING INFORMATION:

1. Homestead Value (from property tax bill) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. HOUSEHOLD INCOME METHOD 2. Household Income (from Form HI-144, Line t) HOMESTEAD EXCLUSION METHOD 5. Homestead School Property Tax (from Property Tax Bill) subtract 6. multiplied by 3. Household Income % (HIP) (Table A, page 11)

equals

4. Income Sensitized School Property Taxes

00
Homestead Exclusion Value (HEV) (Table A, page 11)

equals

7. Homestead Sensitized School Property Taxes

F COPY O ILL A TTAC7,H is less.) .Y. . . T.A. .X. . . B. . . . . . . . . . . . . 9. 9. ACT 60 SENSITIZED HOMESTEAD SCHOOL PROPERTY TAX (Enter Line 4 or Line whichever .. ... .. .. ... A E.R. T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. 10. Homestead School Property Tax Benefit (Subtract Line 9 from Line 8 and enter result here.) . . . . . . . . PROP UR may exceed the Benefit for homeowners who received a rebate . . . . . . . . . 11. YO 11. 2000 Prebate (Estimated Property Tax Benefit Payment) NOTE: Prebate
8. Homestead School Property Tax (from Line 5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. last year as an advance rebate payment was included in the prebate. If eligible, go to Schedule A to complete benefit. 12. ADDITIONAL SCHOOL PROPERTY TAX BENEFIT. If Line 11 is LESS than Line 10, subtract Line 11 from Line 10 and enter result here. . . . . . . . . . . 12. If Line 2 is over $47,000 STOP HERE. Also enter on IN-111, Section 8, Line 5. 13. REPAYMENT OF EXCESS PREBATE. If Line 11 is MORE than Line 10, subtract Line 10 from Line 11 and enter result here . . . . . . . . . . . . . . . . . . . . . 13. If Line 2 is over $47,000 STOP HERE. Also enter on IN-111, Section 3, Line 7.

DO YOU HAVE $47,000 OR LESS IN HOUSEHOLD INCOME?

Go to Schedule A, Homeowner Property Tax Rebate, to see if you qualify for additional homestead property tax benefit.

On back of form: Signature block (required) 2001 Prebate Election Schedule A, Homeowner Property Tax Rebate

continued on back

Form HS-133 XX

FOR HOUSEHOLD INCOME OF $47,000 OR LESS, first complete SCHEDULE A (below)

14. Homeowner Property Tax Rebate (From Schedule A, Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. 15. ADDITIONAL SCHOOL PROPERTY TAX BENEFIT. Add Line 12 and 14 and enter result here OR If Line 14 is more than Line 13, subtract Line 13 from Line 14 and enter result here If Line 14 is 0 enter Line 12 amount here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. When required to file an income tax return, also enter this amount on Form IN-111, Section 8, Line 5. 16. REPAYMENT OF EXCESS PREBATE DUE. If Line 14 is smaller than Line 13, subtract Line 14 from Line 13 and enter result here If Line 14 is 0 enter Line 13 amount here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. When required to file an income tax return, also enter this amount on Form IN-111, Section 3, Line 7.

SCHEDULE A. HOMEOWNER PROPERTY TAX REBATE CLAIM

$47,000 OR LESS HOUSEHOLD INCOME

F COPY O ILL ACH A 3. Allowable Homestead Property Taxes (Add Line 1 and Line ATT 2 and enter result here.) . . . . . . . . . . . . . . . . . . . . .TAX. . .B. . . . . . . . . . . . 3. .......... ... E.R. T.Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 4. If Applicable: Lot Rent for Mobile Home (From Form LC-142) . . . . . . . .P.ROP . . . . . . . . . . . . ... ............ OUR Y
1. Act 60 Sensitized Homestead School Property Tax (From Side 1, Line 9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 5. Rebate Eligible Homestead Property Taxes (Add Line 3 and Line 4 and enter result here.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 6. Household Income (From Form HI-144, Line t) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. 7. Maximum Percent of Income for Property Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. If Line 6 Household Income is: Enter this % on Line 7: $0 4,999 3.5% $5,000 9,999 4.0% $10,000 24,999 4.5%

2. Homestead Municipal Property Tax (From Property Tax Bill) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.

$25,000 47,000 5.0%

8. Maximum Allowable Homestead Property Taxes for Household Income (Multiply Line 6 by Line 7 and enter result here.) . . . . . . . . . . . . . . . 8. IF LINE 8 IS MORE THAN LINE 5, YOU DO NOT QUALIFY FOR A REBATE. 9. Rebate (Subtract Line 8 from Line 5. Enter result here and on Line 14 of Property Tax Calculation above.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.

DO YOU WANT TO RECEIVE A PROPERTY TAX PREBATE IN 2001?

To be eligible: You must expect to be a Vermont resident all of 2001 and own a Vermont homestead on December 31, 2001. A prebate is an CHECK estimate of your Act 60 benefit based on Line 10 and Line 14. IF YOU RECEIVE A PREBATE, YOU MUST FILE AN ACT 60 PROPERTY HERE TAX CALCULATION FORM IN 2002. You may be entitled to additional benefit or required to repay any excess prebate payment.

SIGN HERE
Keep a copy for your records.

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Preparers cannot use return information for purposes other than preparing returns. Your signature Spouses signature. If a joint return, BOTH must sign. Date Date

Check here if authorizing the Vermont Department of Taxes to discuss this return and attachments with your preparer. Preparers signature Date Check if self-employed

Paid Preparers Use Only

Preparers SSN or PTIN EIN ZIP code

Firms name (or yours if self-employed) and address

Form HS-133 XX