Form Hs 122 PDF Details

The Form HS-122 is a crucial document for Vermont residents, incorporating both the Vermont Homestead Declaration and the Property Tax Credit Claim under Act 51, which saw revisions effective July 1, 2019. This form is essential for homeowners seeking to declare their property as a homestead and to claim a property tax credit, provided that certain conditions are met. For instances, it stipulates that a Vermont homestead must be the principal dwelling and surrounding parcel of land owned and occupied by a resident as their domicile on April 1 of the filing year. The form also outlines eligibility requirements for the Property Tax Credit, predicated not only on making a Homestead Declaration but also on filing a Property Tax Credit Claim alongside Schedule HI-144, Household Income. It illustrates a shift from prior years in response to legislative changes, exemplifying Vermont's approach to property tax adjustments and highlighting the importance of timely filing by the due date to avoid penalties. The form’s detailed instructions, including the need to file annually, underscore the Vermont Department of Taxes' move towards streamlined, resident-focused tax declaration and credit processes, including the encouragement of online filing for added convenience.

QuestionAnswer
Form NameForm Hs 122
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other nameshs 122, how to vt homestead declaration, vermont form, vermont state tax form

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STOP: DO NOT USE FOR 2021 HOMESTEAD

DECLARATION AND PROPERTY TAX CREDIT FILING

This form is for last year’s filing and will not be accepted for tax

year 2021 homestead declaration and property tax credit filing.

 

 

Vermont Department of Taxes

*2012211WW*

 

 

2020 Form HS-122

 

 

 

Vermont Homestead Declaration AND

* 2 0 1 2 2 1 1 W W *

 

 

Property Tax Credit Claim

 

Under Act 51, effective July 1, 2019, the Property Tax Adjustment has been changed to the Property Tax Credit.

DUE DATE: April 15, 2020. You may file up to Oct. 15, 2020, but the town may assess a penalty. For details on late filing, see the instructions.

How to file a Homestead Declaration: Please complete Section A of this form, sign in the signature section at the bottom of page 2, and send the form to the Vermont Department of Taxes

How to file a Property Tax Credit Claim: To be considered for a Property Tax Credit, you must file a 1) Homestead Declaration (Section A of this form), 2) Property Tax Credit Claim (Section B of this form), and 3) Schedule HI-144, Household Income. Sign this form in the signature section at the bottom of page 2 and send the forms to the Department.

Tired of paper forms? It’s fast and convenient to file your claim online at myVTax.vermont.gov.

Annual Vermont Homestead Declaration

This form must be filed each year by every Vermont resident whose property meets the definition of a homestead.

A Vermont homestead is the principal dwelling and parcel of land surrounding the dwelling, owned and occupied by a resident SECTION A. individual as the individual’s domicile on April 1, 2020. If your homestead is leased to a tenant on April 1, 2020, you may still

claim it as a homestead if it is not leased for more than 182 days in the 2020 calendar year.

Please PRINT in BLUE or BLACK INK

Claimant’s Last Name

 

First Name

 

 

MI

 

Claimant’s Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Spouse’s/CU Partner’s Last Name

First Name

 

 

MI

 

Spouse’s or CU Partner’s Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (Number and Street/Road or PO Box)

 

 

 

 

 

 

 

 

 

Claimant’s Date of Birth (MMDDYYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

/

 

 

 

 

 

 

 

City

 

 

State

 

ZIP Code

 

 

 

SPAN - REQUIRED (From the 2019/2020 property tax bill)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Location of Homestead (Use a number, street/road name. Do not use a PO Box or “same.”)

 

 

 

City/Town of Legal Residence on April 1, 2020

&

State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Federal

 

Single

 

 

 

 

Married/CU

 

 

Married/CU

 

 

 

Head of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Filing Status

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Filing Jointly

 

 

Filing Separately

 

 

 

Household

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A1. Business Use of Dwelling

. .

. . . .

. .

 

.

. . . . . . . . . . . . . . . . . . . . . . . . .

. .

. .

.

. . . . . . . . . . . . . . . . .

A1.

__________________ %

A2. Rental Use of Dwelling

. .

. . . .

. .

 

.

. . . . . . . . . . . . . . . . . . . . . . . . .

. .

. .

.

. . . . . . . . . . . . . . . . .

A2.

__________________ %

A3. Business or Rental Use of Improvements or Other Buildings

 

 

 

 

 

 

 

 

 

 

 

 

. .Not including the dwelling, are improvements or other buildings located on your parcel used for business or rented?

. . A3.

 

Yes

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A4-A7 Special Situations (see instructions for more information). Check the following if it applies:

A4.

Grantor and sole beneficiary of a revocable trust owning the property

A6.

Homestead property crosses town boundaries (File a declaration for each town.)

A5. Life estate holder of the property

A7.

Residing in a dwelling on the homestead parcel owned by a related farmer.

Please continue to Page 2, Part B, for property tax credit. Sign on Page 2.

Mail to: Vermont Department of Taxes

PO Box 1881

Montpelier, VT 05601-1881

5432

 

Form HS-122

Page 1 of 2

Rev. 10/19

Claimant’s Last Name

Social Security Number

 

 

DUE DATE: April 15, 2020. Claims accepted up to Oct. 15, 2020.

*2012212WW*

* 2 0 1 2 2 1 2 W W *

SECTION B.

PROPERTY TAX CREDIT CLAIM

For Household Income up to $138,250. Complete and attach Schedule HI-144.

To qualify, you must meet the requirements for filing a homestead declaration in addition to the following requirements. ALL eligibility questions must be answered.

B1. Were you domiciled in Vermont all of calendar year 2019? . . . . . . .

B2. Were you claimed as a dependent in 2019 by another taxpayer? . . . .

B3. Do you anticipate selling this Vermont housesite on or

before April 1, 2020? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes, Go to Line B2.

Yes, STOP.

Yes, STOP.

No, STOP.

No, Go to Line B3.

No, Continue

Amounts for Lines B4-B6 are found on the 2019/2020 property tax bill. Round amounts to the nearest dollar.

B4.

Housesite Value

. . . . . . . . . . . . . . . . . . . . . . . . . . .

.B4. __________________________.00

B5.

Housesite Education Tax

 

B5. __________________________.00

B6.

Housesite Municipal Tax

. . . . . . . . . . . . . . . . . . . . . . . . . . .

.B6. __________________________.00

B7.

Ownership Interest

. . . . . . . . . . . . . . . . . . . . . . . . . . .

. .

. .

. . .B7. __________________ %

B8.

Household Income (Schedule HI-144, Line z).

B8. _____________________ .00

 

 

Check here if amended Schedule

 

 

 

You MUST attach Schedule HI-144

 

 

 

 

 

HI-144, Household Income, is included.

Complete the following ONLY if applicable. See instructions for details.

Lot Rent

 

-

B9.

E-file Certificate Number (From Form LC-142)

.B9.

______________________________

B10.

Mobile Home Lot Rent (Allocable Rent from Form LC-142 - include Form LC-142 with claim.)

B10.

__________________________.00

 

 

 

 

 

OR Allocated Property Tax from Land Trust, Cooperative, or Nonprofit Mobile Home Park

 

__________________________.00

B11. Allocated Education Tax

B11.

B12.

Allocated Municipal Tax

B12.

__________________________.00

 

 

 

 

OR Property Tax from contiguous property if housesite has less than 2 acres (see instructions.)

 

__________________________.00

B13. Contiguous property Education Tax

B13.

B14.

Contiguous property Municipal Tax

B14.

__________________________.00

MAXIMUM CREDIT AMOUNT IS $8,000.

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.

Signature

Date (MMDDYYYY)

Daytime Telephone Number

 

 

 

Signature (If a joint return, BOTH must sign.)

Date (MMDDYYYY)

Daytime Telephone Number

 

 

 

Paid Preparer’s Signature

Date (MMDDYYYY)

Preparer’s Telephone Number

 

 

 

Firm’s Name (or yours if self-employed) and address

Preparer’s SSN or PTIN

EIN

 

 

 

Check if the Department of Taxes may discuss this return with the preparer shown.

5432

Page 2 of 2

Form HS-122 Rev. 10/19

Vermont Department of Taxes

*1914421WW*

2019 Schedule HI-144

Household Income

* 1 9 1 4 4 2 1 W W *

Please PRINT in BLUE or BLACK INK

For the year Jan 1 - Dec 31, 2019

 

This schedule must be included with the 2019 Renter Rebate Claim (Form PR-141) OR the 2020 Property Tax Credit Claim (Form HS-122) UNLESS you are filing an AMENDED HI-144. Please read instructions before completing schedule.

Claimant’s Last Name

First Name

MI

Claimant’s Social Security Number

Spouse’s/CU Partner’s Last Name

First Name

MI

Claimant’s Date of Birth (MMDDYYYY)

List the names and Social Security Numbers of all other persons (in addition to a Spouse or CU Partner) who had income and lived with you during 2019. Include both their taxable and non-taxable income in Column 3. If you have more than two “Other Persons” living in your household, record the names and Social Security Numbers on a separate sheet of paper and include with the filing.

Other Person #1 Last Name

First Name

MI

Other Person #1 Social Security Number

 

 

 

 

Other Person #2 Last Name

First Name

MI

Other Person #2 Social Security Number

 

 

 

 

Yearly totals of ALL

1. Claimant and

members of the household

jointly filed Spouse

a. Cash public assistance and relief

a.____________.00

b. Social Security, SSI, disability, railroad retirement,

b.____________.00

veteran’s benefits, taxable and nontaxable

c. Unemployment compensation/worker’s compensation

c.____________.00

d. Wages, salaries, tips, etc. (See instructions for

d.____________.00

dependent’s exempt income.)

e. Interest and dividends

e.____________.00

f. Interest on U.S., state, and municipal obligations,

.f.____________.00

taxable and nontaxable

g. Alimony and support money

g.____________.00

h. Child support and cash gifts

 

Please specify__________________________

h.____________.00

i. Business income. If the amount is a loss, enter -0-.

.i.____________.00

See instructions for offsetting a loss

j. Capital gains, taxable and nontaxable. If the amount is a loss,

.j.____________.00

enter -0-. See instructions for offsetting a loss

k. Taxable pensions, annuities, IRA and other retirement fund and

k.____________.00

distributions. See instructions

l. Rental and royalty income. If the amount is a loss, enter -0-.

.l.____________.00

See instructions for offsetting a loss

m. Farm/partnerships/S corporations/LLC/Estate or Trust income.

 

If the amount is a loss, enter -0-. See Line m instructions for only

m.____________.00

exception to offset a loss

n. Other income (see instructions for examples of other income)

 

Please specify__________________________

n.____________.00

2.Filing separately Spouse or CU Partner

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

3.Other Persons

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

___________ .00

o. Total Income: Add Lines a through n

. . . o. _____________.00

 

5432

Page 1 of 2

 

 

 

 

_____________ .00

_____________.00

Schedule HI-144

Rev. 10/19

1. Claimant and
jointly filed Spouse

Claimant’s Last Name

Social Security Number

*1914422WW*

* 1 9 1 4 4 2 2 W W *

Carried forward from Line o

_____________ .00

_____________ .00

_____________ .00

 

 

 

 

p. See instructions. Enter Social Security and Medicare tax withheld on wages claimed on Line d. Self-Employed: Enter self-employment tax from Federal Schedule SE. This entry may differ from W-2/1099 or Federal Schedule SE amount if these taxes are paid on income not required to be reported on Schedule HI-144. Include W-2 and/or Federal Schedule SE

if not included with income tax filing . . . . . p.____________ .00

q. Child support paid. You must include

proof of payment. See instructions . . . . . . . q._____________ .00

2.Filing separately Spouse or CU Partner

____________.00

_____________ .00

3.Other Persons

____________.00

_____________ .00

Support paid to: Last Name

First Name

MI

Social Security Number

r.Allowable adjustments from Federal Form 1040

r1.

Business expenses for Reservists . . . .r1.

___________ .00

r2.

Alimony paid

r2.

___________ .00

r3.

Self-employed health

 

___________ .00

 

insurance deduction

r3.

r4.

Health Savings Account deduction . . .

r4.

___________ .00

r5.

Tuition and Fees

r5.

___________ .00

s. Add Lines p, q, and total of Lines r1 to r5

 

___________ .00

for each column

s.

t. Subtract Line s from Line o of each column.

___________ .00

If a negative amount, enter -0-

t.

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

____________.00

u. Add all three amounts from Line t. If a negative amount, enter -0-

u. ___________ .00

v.Complete if born Jan. 1, 1955 and after. Enter interest and dividend income from

Lines e and f

v. ___________ .00

____________.00

____________.00

 

w. Add all three amounts from Line v

. . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . w. ___________ .00

x

. . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . .

. . .x.

10,000.00

y. Subtract Line x from Line w. If Line x is more than Line w, enter -0- . .

. . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . y. ___________ .00

z. HOUSEHOLD INCOME. Add Line u and Line y

. . . . . . . . . . . z. ___________ .00

RENTERS If Line z Household Income is $47,000 or less, you may be eligible for a renter rebate . Complete Form PR-141 Renter Rebate Claim . This schedule must be filed with the Renter Rebate Claim. Claims are due April 15, 2020, but can be filed up to Oct. 15, 2020.

If Household Income is more than $47,000, you do not qualify for a renter rebate.

HOMEOWNERS Form HS-122, Homestead Declaration AND Property Tax Credit Claim, must be filed each year.

Homeowners with Household Income up to $138,250 on Line z should complete Form HS-122, Section B. You may be eligible for a property tax credit. This schedule must be filed with Form HS-122.

Form HS-122 The due date to file is April 15, 2020. Homeowners filing a property tax credit, Form HS-122 and Schedule HI-144, between April 16 and Oct . 15, 2020, may still qualify for a Property Tax Credit . A $15 late filing fee will be deducted from the credit.

5432

 

Schedule HI-144

Page 2 of 2

Rev. 10/19

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With regards to the blanks of this particular form, here is what you need to know:

1. For starters, while completing the form hs 122, start out with the page containing subsequent fields:

The best ways to fill in form hs 122 printable step 1

2. After the last section is done, it is time to include the required details in Claimants Last Name, Social Security Number, DUE DATE April Claims accepted, SECTION B, For Household Income up to, PROPERTY TAX CREDIT CLAIM, To qualify you must meet the, B Were you domiciled in Vermont, Yes Go to Line B, No STOP, B Were you claimed as a dependent, Yes STOP, No Go to Line B, B Do you anticipate selling this, and before April allowing you to go further.

Yes Go to Line B, Social Security Number, and DUE DATE April   Claims accepted in form hs 122 printable

3. This next section will be about Complete the following ONLY if, B Lot Rent Allocable Rent from, Allocated Property Tax from Land, B Allocated Education Tax, B Allocated Municipal Tax, OR Property Tax from contiguous, B Contiguous property Education, B Contiguous property Municipal, Under penalties of perjury I, MAXIMUM CREDIT AMOUNT IS, Signature, Signature If a joint return BOTH, Paid Preparers Signature, Date MMDDYYYY, and Daytime Telephone Number - complete every one of these blanks.

Tips on how to prepare form hs 122 printable stage 3

Always be really attentive when filling out Allocated Property Tax from Land and Date MMDDYYYY, since this is the part in which most people make a few mistakes.

4. This next section requires some additional information. Ensure you complete all the necessary fields - Firms Name or yours if, Preparers SSN or PTIN, FEIN, Check if the Department of Taxes, and Form HS Page of Rev - to proceed further in your process!

form hs 122 printable completion process explained (step 4)

5. This form should be completed with this particular part. Further you can find a comprehensive list of form fields that require accurate information in order for your form usage to be complete: Claimants Last Name, SpousesCU Partners Last Name, First Name, First Name, Claimants Social Security Number, Claimants Date of Birth MMDDYYYY, List the names and Social Security, Other Person Last Name, Other Person Last Name, First Name, First Name, Other Person Social Security, Other Person Social Security, Yearly totals of ALL, and members of the household.

Tips on how to complete form hs 122 printable portion 5

Step 3: Before finishing this form, check that all form fields were filled out the proper way. When you confirm that it is correct, click “Done." Join us now and easily get access to form hs 122, available for downloading. All modifications made by you are kept , which means you can change the form at a later point as needed. When using FormsPal, you can complete forms without stressing about database leaks or entries being shared. Our protected system makes sure that your private information is kept safely.