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State of Rhode Island Division of Taxation
2023 Form RI-1040H
Rhode Island Property Tax Relief Claim 23100299990101
First nameYour first name MI Last name MI Last name Suffix Deceased?Deceased?Deceased? Y YYour social security numberour social security numberour social security number
YeYess
Spouse’s first name MI Last name Suffix Deceased?Deceased? Spouse’Spouse’s social security numbers social security number
YeYess
Mailing addressMailing address New address?New address? Daytime telephone numberDaytime telephone number
YeYess
CityCity, town or post office, town or post office StateState ZIP codeZIP codeZIP code CityCityCity ororor towntowntown ofofof legallegallegal residenceresidenceresidence
HomeHomeHomeHome Address if using a PO Box or if your Mailing Address is different from Home AddressAddressEmailEmailEmailEmailif usingaddressaddressaddressaddressa PO Box or if your Mailing Address is different from Home AddressAddress if using a PO Box or if your Mailing Address is different from Home AddressAddress if using a PO Box or if your Mailing Address is different from Home Address
PART 1ELIGIBILITY. IF YOU ANSWER NO TO ANY OF THESE QUESTIONS, YOU ARE NOT ELIGIBLE FOR THIS CREDIT.
STOP HERE. DO NOT COMPLETE THE REST OF THIS FORM.
A Were you domiciled in Rhode Island for all of 2023?.................................................................................. A YES NO
B In 2023 did you live in a household or rent a dwelling that was subject to property tax?............................ B YES NO
C Are you current for property taxes or rent due on the homestead for 2023 and all prior years?................. C YES NO
D Were you or your spouse 65 years of age or older and/or disabled as of December 31, 2023?................ D
ELIGIBILITY YES NO
E Was your 2023 total household income from page 2, line 32 $37,870 or less?.......................................... E YES NO
PART 2 ADDITIONAL INFORMATION - ATTACH A COPY OF YOUR 2023 SOCIAL SECURITY AWARD LETTER OR FORM 1099 TO 1040H FORM
1a Enter the total amount of public assistance received by all members of your household........................... 1a
b Enter your total household income from page 2, line 32............................................................................. 1b
c Enter your date of birth ............................ / / 1d Enter spouse's date of birth ..................... / /
INFO e Were you or your spouse disabled and receiving Social Security Disability payments during 2023? 1e YES NO
f Indicate the number of persons in your household ..................................................................................... 1f
g Enter the number of persons from 1f who are dependents under the age of 18........................................ 1g
PART 3 TO BE COMPLETED BY HOMEOWNERS ONLY– ATTACH A COPY OF YOUR 2023 PROPERTY TAX BILL TO 1040H FORM
2 Enter the amount of property taxes you paid or will pay for 2023............................................................... 2
3 Using your household income from line 1b enter percentage from the computation table located on pg 3 3 %
4 Multiply amount on line 1b by percentage on line 3.................................................................................... 4
HOME 5 Tentative credit. Subtract line 4 from line 2. If line 4 is greater than line 2, enter zero.............................. 5
OWNERS 6 PROPERTY TAX RELIEF. Line 5 or $650.00, whichever is LESS.............................................................. 6
PART 4 TO BE COMPLETED BY RENTERS ONLY– ATTACH A COPY OF YOUR 2023 LEASE OR 3 RENT RECEIPTS TO 1040H
LANDLORD INFORMATION (REQUIRED)
Name: Address: Telephone number:
7 Enter the amount of rent you paid in 2023.................................................................................................. 7
8 Multiply the amount on line 7 by twenty (20) percent (0.2000).................................................................... 8
9 Using your household income from line 1b enter percentage from the computation table located on pg 3 9 %
10 Multiply amount on line 1b by percentage on line 9.................................................................................... 10
11 Tentative credit. Subtract line 10 from line 8. If line 10 is greater than line 8, enter zero.......................... 11
RENTERS 12 PROPERTY TAX RELIEF. Line 11 or $650.00, whichever is LESS............................................................ 12
CREDIT 13 PROPERTY TAX RELIEF. Line 6 or line 12, whichever applies. Enter here and on Form RI-1040, line 14c....... 13
RETURN MUST BE SIGNED - SIGNATURE IS LOCATED ON PAGE 2
Mailing address: RI Division of Taxation, One Capitol Hill, Providence, RI 02908-5806
