Iowa Renters Rebate Form PDF Details

Are you an Iowa resident looking for financial relief to help cover rental costs? If so, you may be eligible for a tax-free rent rebate from the state of Iowa. The program, known as the Iowa Renters Rebate Program, is available to qualifying applicants and provides some much needed financial support during these uncertain times. This blog post will provide detailed information on how to apply for the rebate and what documentation is required in order to receive it. Keep reading if you need assistance with completing your renters rebate form!

QuestionAnswer
Form NameIowa Renters Rebate Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names2020 iowa rent reimbursement claim form, rent rebate iowa, iowa rent rebate form 2021, rent rebate form

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2020 IOWA RENT REIMBURSEMENT CLAIM

Page 1

tax.iowa.gov

Name and address:

•Complete using blue or black ink only. Do not use pencil or gel pen.

•Incomplete claims will delay processing. You may be contacted for additional information.

•Married couples living together are considered one household and can file only one claim, combining both incomes. If you do not live together, you may file separate claims.

Print your last name, first name:

Birth date (MMDDYYYY):

Print spouse last name, first name:

SSN:

Birth date (MMDDYYYY):

SSN:

Current mailing address (Include unit number): ______________________________________________

City:________________________________________________ State: _________ ZIP: ____________

Who is eligible:

 

 

1.

Were you (or your spouse) born before 1956?

Yes

No

2.

Were you (or your spouse) born between 1956 and 2002 and totally disabled? ....

Yes

No

 

Include a copy of your letter that shows you are disabled from the Social

 

 

Security Administration, Veterans Administration, your doctor, or Form SSA-1099. If you answered “no” to both questions 1 and 2, STOP; YOU DO NOT QUALIFY.

3.

Did you live in Iowa during 2020? If “no,” STOP; YOU DO NOT QUALIFY

Yes

4.

Do you currently live in Iowa? If “no,” STOP; YOU DO NOT QUALIFY

Yes

Total annual household benefits and income:

For you and your spouse even if not reported for Iowa individual income tax purposes. Send proof of income.

No No

5.HUD, Section 8, and any portion of rent or utilities paid for you

6.Title 19 benefits for housing only................................................................. ................

If you lived in a nursing home or care facility, contact the administrator for amount to enter on line 6. Or, enter 20% of benefits if living in a nursing home or 40% if living in a care facility.

7.Gross Social Security income. Include SSI and Medicare premium withheld. ............

8.Gross disability income. Include SSDI, VA, and Railroad. Provide proof of disability......

9.Wages, salaries, unemployment compensation, etc....................................

10.All pension, IRA, and annuity income. Include military retirement pay

11.Interest and dividend income.......................................................................

12.Profit from business/farming/capital gain.....................................................

13.Cash or checks received from others living with you. ..................................

14.Other benefits and income............................................................................................

Include child support, alimony, FIP, children’s SSI, welfare payments, gambling, etc.

15. Total annual household benefits and income. Add lines 5 through 14.........

Is line 15 $24,206 or more?

If yes, STOP; YOU DO NOT QUALIFY.

,

,

,

,

,

,

,

,

,

,

,

.00

.00

.00

.00

.00

.00

.00

.00

.00

.00

.00

54-130a (05/08/2020)

Continue on next page

2020 IOWA RENT REIMBURSEMENT CLAIM, Page 2

Rental information: Complete the Statement of Rent Paid if you lived in more than one place.

16. Did you live in a nursing home or care facility? If yes, report Title 19 benefits on line 6. Yes

No

17.Rental address. The location where you lived must be subject to property tax. You are not eligible for rent reimbursement if the location or nursing home was not subject to property tax.

Dates you rented in 2020 (MMDDYY): from

to

Total Iowa rent you paid at this location...................................................

,

.00

Street (PO Box not allowed): ______________________________________________________

City:___________________________________________ State:

ZIP:

Landlord or nursing home:

 

 

 

Name: _________________________________________ Phone number: (

)

 

 

 

 

 

Address: ______________________________________________________________________

City:___________________________________________ State: ________ ZIP:____________

If you lived in more than one location, complete the Statement of Rent paid for all other locations.

18. Total Iowa rent you paid in 2020. Add rent for all locations...........................

,

.00

This section optional: Complete lines 19 to 21 below, or allow the department to compute for you.

19. Rent eligible for reimbursement. Multiply line 18 by 0.23, enter result. ......

,

.00

If more than 1,000, enter 1,000. Example: if line 18 = 3,900, multiply 3,900 x 0.23 = Enter 897 on line 19

20. Select rate from table below based on total benefits and income on line 15:

X

.

$0.00 -

$12,469.99

enter 1.00

$18,338 -

$21,271.99

enter 0.35

$12,470 - $13,936.99

enter 0.85

$21,272 -

$24,205.99

enter 0.25

$13,937 -

$15,403.99

enter 0.70

$24,206 or greater....STOP; you do not qualify.

$15,404-

$18,337.99

enter 0.50

 

 

 

21. Estimated reimbursement. Multiply line 19 by line 20

 

,

Example: line 19 = 897, multiply 897 by 0.70 = 628, enter on line 21.

Direct deposit information:

.00

To receive direct deposit of your reimbursement to your account, complete lines A and B.

A.Routing number:

B.Account number:

Type: Checking

Savings

I, the undersigned, declare under penalties of perjury or false certificate, that I have examined this claim, and, to the best of my knowledge and belief, it is true, correct, and complete.

 

 

 

 

 

 

 

 

 

 

If deceased,

Your signature:

 

 

 

 

 

Date:

 

 

 

date of death:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If deceased,

Spouse signature:

 

 

 

 

Date:

 

 

 

date of death:

Your phone number: (

)

Preparer phone number: (

)

 

 

Preparer name:

 

 

Preparer signature:

 

Date:

►Include proof of income and rent paid. If under 65, also include proof of disability.

Mail to: Rent Reimbursement, Iowa Department of Revenue, PO Box 10459, Des Moines, IA 50306-0459. To check the status of a refund visit tax.iowa.gov or call 1-800-572-3944.

54-130b (07/20/2020)

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This document will need specific details to be filled out, so you need to take your time to type in what's asked:

1. To begin with, when filling in the iowa rent reimbursement, beging with the page that has the following fields:

Part no. 1 in completing rent reimbursement form

2. The third stage is usually to fill in all of the following fields: Title benefits for housing only, Gross Social Security income, Gross disability income Include, Wages salaries unemployment, All pension IRA and annuity, Interest and dividend income, Profit from, Cash or checks received from, Other benefits and income, Include child support alimony FIP, Total annual household benefits, and Is line or more If yes STOP YOU.

Find out how to complete rent reimbursement form step 2

3. The following step is related to Rental information Complete the, Did you live in a nursing home or, rent reimbursement if the location, Dates you rented in MMDDYY, from, Total Iowa rent you paid at this, Street PO Box not allowed City, ZIP, Landlord or nursing home, Name Phone number Address City, If you lived in more than one, Total Iowa rent you paid in Add, and This section optional Complete - type in these empty form fields.

Landlord or nursing home, Street PO Box not allowed City, and Did you live in a nursing home or in rent reimbursement form

Lots of people generally make errors when filling in Landlord or nursing home in this part. You need to double-check what you enter right here.

4. To go forward, this step will require typing in a few blank fields. Included in these are Rent eligible for reimbursement, enter enter enter, enter enter or, Estimated reimbursement Multiply, Example line multiply by, Direct deposit information To, A Routing number, B Account number, Type Checking, Savings, I the undersigned declare under, Your signature, Spouse signature, Date, and Date, which are fundamental to continuing with this PDF.

Type Checking, Date, and Direct deposit information To inside rent reimbursement form

5. Because you near the finalization of the document, there are actually just a few extra things to undertake. Mainly, Spouse signature, Date, If deceased date of death If, Your phone number Preparer name, Preparer phone number Preparer, Date, and To check the status of a refund should be filled out.

Date, Spouse signature, and If deceased date of death If inside rent reimbursement form

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