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                       IMPORTANT! 
                    2008 Reimbursement Recipients
 If you applied for and received a 2008 property tax reimbursement, you should have received a personalized 
 application preprinted with information you provided last year. If you qualify for a 2009 property tax 
 reimbursement, be sure to use the personalized application. If you have not received your personalized 
 application, please call 1-800-882-6597 and one will be mailed to you.

Introduction                                              Qualifications
The Property Tax Reimbursement Program is                 To qualify for the 2009 reimbursement, an appli-
  designed to reimburse senior citizens and dis-          cant must meet all of the following   requirements:
abled persons for property tax increases. For ap-         • For 2008 and 2009, you must have been age 65 
plicants who met all the eligibility requirements for       or older or receiving Federal Social Security dis-
2008, and again for 2009, the amount of the 2009            ability beneits as of December 31. If receiving 
reimbursement will be the difference between                Federal Social Security disability, you (or your 
the amount of property taxes that were due and              spouse/civil union partner) must have been re-
paid by the applicant for 2008 and the amount of            ceiving such beneits based on your own social 
property taxes that were due and paid for 2009,             security number (you do NOT qualify if you were 
provided, of course, that the amount paid for 2009          receiving beneits on behalf of someone else); 
was greater than the amount paid for 2008. For              and
mobile home owners, property tax means 18% of 
                                                          •  You must have lived in New Jersey continuously 
the annual site fees paid to the owner of a mobile 
                                                            since before January 1, 1999, as either a home
home park.
                                                            owner or a renter; and
Homeowners and mobile home owners who are                 •  You must have owned and lived in your home 
receiving homestead rebates and/or property tax             (or have leased a site in a mobile home park on 
credits or deductions may also receive the prop-            which you have placed a manufactured or mo-
erty tax reimbursement if they meet the eligibility         bile home that you own) since before January 1, 
requirements. However, the total of all property tax        2006; and
relief beneits that you receive for 2009 (property        •  You must have paid the full amount of the 
tax reimbursement, homestead rebate, property               property taxes due on your home:
tax deduction for senior citizens/disabled persons, 
                                                            For 2008:  By June 1, 2009, and
and property tax deduction for veterans) cannot 
                                                            For 2009:  By June 1, 2010; 
exceed the amount of 2009 property taxes (or                                            and
rent/site fees constituting property taxes) paid for      •  Your total annual income must have been:
your residence.                                             For 2008:  $70,000 or less, and
                                                            For 2009:  $80,000 or less
NO T E: Beneits available under this program 
        may be affected by State budgetary                  These limits apply regardless of your marital/
        constraints. Please check our Web site              civil union status. However, if your status at 
                                                            Line 2, and/or Line 3, Form PTR1, is married/
        at www.state.nj.us/treasury/  taxation/
                                                            CU couple, you must report combined income 
        propfrez.shtml or call 1-800-323-4400 
                                                            of both spouses/CU partners for that year.
        for updated information on beneit 
        amounts and payment   information.                NO T E: 
                                                          (1) You may not apply for a reimbursement for 
                                                            a vacation home, a “second home,” or a 
               Reminder                                     property that you rent to someone else.
The Homestead Rebate and Property Tax Reim  -             (2) You may not apply for a reimbursement for 
burse  ment Pro  grams are separate   programs and          a property that consists of more than four 
  separate appli  ca  tions must be iled   every year for   units OR for a property with four units or 
each program.                                               less that contains more than one commer-
                                                            cial unit.
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2009 Form PTR-1 Instructions

Income Standards                                            property (tangible or intan  gible) seized, lost, or 
With very few exceptions, A L L I N C O M E that you re-    misappropriated as a result of Nazi actions or 
ceived during the year, including income which              policies and any cash values in replacement of 
you are not required to report on your New Jersey           such property; payments of insurance policies 
income tax return, must be taken into account to            purchased by victims of Nazi persecution; and 
determine eligibility for the property tax reimburse-       any accumulated or accrued interest on such 
ment. Income limits for eligibility are subject to ad-    •  Beneit amounts received under the New Jersey 
justment annually.                                          State Lifeline Credit Program/Tenants Lifeline 
                                                            Assistance Program
If you have a loss in one category of income,             •  Beneits received as either New Jersey 
it may be applied against income in the same 
                                                              homestead, FAIR, or   SAVER rebates
  cate  gory. However, if you have a net loss in one 
                                                          •  Federal economic stimulus payments to individ-
category of income, it cannot be applied against 
                                                            uals under the Economic Stimulus Act of 2008
  income or gains in another. In the case of a net 
                                                          •  Capital gains on the sale of a principal resi-
loss in any category, make no entry on the corre-
                                                            dence after May 6, 1997, of up to $250,000 
sponding line.
                                                            if single, and up to $500,000 if married/CU 
Examples of possible sources of income (gross               couple. Capital gains in excess of the allowable 
amounts unless otherwise noted) are as follows:             exclusion must be included in income. (Capital 
                                                            gains and the exclusion of all or part of the gain 
•  Social Security Beneits 
                                                            on the sale of a prin  cipal residence are com-
 (including Medicare Part B premiums)
                                                            puted in the same manner for both Federal and 
•  Total Pension Income 
                                                            State income tax purposes.)
 (including annuity or IRA distributions and 
                                                          •  Stipends from the Volunteers in Service to 
   beneit payments from foreign countries)
                                                            America (VISTA), Foster Grandparents, and 
•  Salaries and Wages, Bonuses, Commissions, 
                                                            Workforce 55+ programs; and programs under 
 and Fees
                                                            Title V of the Older Americans Act of 1965
•  Unemployment Beneits
                                                          •  Proceeds received from a spouse’s/civil union 
•  Disability Beneits (including veterans’ and black 
                                                            partner’s life   insurance policy
 lung beneits)
                                                          •  Proceeds received by the beneiciary of a 
•  Interest (taxable and exempt)
                                                              Special Needs Trust 
•  Dividends
                                                          •  Proceeds received from viatical settlements
•  Net Capital Gains
                                                          •  Agent Orange Payments
•  Net Rental Income
                                                          •  Reparation payments to Japanese Americans 
•  Net Business Income
                                                            by the Federal Government pursuant to   sections 
•  Support Payments
                                                            105 and 106 of the Civil Liberties Act of 1988, 
•  Inheritances
                                                            P.L. 100383 (50 U.S.C. App. 1989b4 and 
•  Royalties
                                                            1989b-5)
•  Fair Market Value of Prizes and Awards
                                                          •  Rewards involving health care fraud or abuse 
•  Net Gambling and Lottery Winnings
                                                            which apply to N.J.A.C. 10:4913.4
 (including New Jersey)
                                                          •  Rollovers from one taxdeferred inancial instru-
•  Bequests and Death Beneits
                                                            ment (pension, annuity, IRA, insurance contract 
•  All Other Income
                                                            or other retirement beneit) to another tax
                                                              deferred inancial instrument
Sources of income which should N O T        be taken into 
                                                          • Tax-free exchanges of a policy or contract han-
account to determine eligibility:
                                                            dled between two insurance companies
•  Reparation or restitution payments to victims of       •  Insurance policyholder’s original contributions if 
 National Socialist (Nazi) persecution; returns of          demutualization of the policy occurs 

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2009 Form PTR-1 Instructions

Filing Requirements NO T E: If you choose to use Form PTR-1A,
you must have Part II completed and
Due Date June 1, 2010
Eligible applicants must ile the 2009 Property Tax certiied by your local tax collector as
Reimbursement Application (Form PTR1) on or to the amount of property taxes due
and paid for both 2008 and 2009. Be
before June 1, 2010. Applications postmarked on
sure to enclose the completed veri-
or before the due date are considered to be iled
ication form with your Form PTR-1
on time. Applica tions postmarked after the due
date are con sidered to be iled late. application.

Co-ops and continuing care retirement facili-
Proof of Age/Disability ties. Residents of cooperative dwelling units and
Applicants 65 years of age or older must submit continuing care retirement facilities must obtain a
proof of age with their applications. Examples of statement from their management indicating their
acceptable documentation include copies of the share of property taxes paid for the residential unit
following: they occupy and submit the statement with Form
• Birth certiicate PTR-1.
• Driver’s license
• Church records multiple owners (if home is owned by more
than one person, other than husband and wife
Applicants who are not 65 years of age or older, or civil union partners). If title to the property is
but are receiving Federal Social Security disability held by the eligible applicant with others as tenants
beneits, must submit a copy of the Social Security in common or joint tenants (except in the case of a
Award Letter indicating that the applicant was re- husband and wife or civil union partners), the ap-
ceiving beneits based on their own social security plicant is only eligible for the proportionate share
number. of the reimburse ment which relects his or her per-
centage of ownership. This is true even if the other
Proof of Payment owner(s) did not reside in the home. The shares of
Applicants are required to submit with their appli- ownership of the property are considered to be held
cations proof of the amount of property taxes that equally by all owners. If the shares of ownership
were due and paid. The Division of Taxation will are not equal, the applicant must provide documen-
accept copies of the following: tation as to the percentage of ownership.

HomeoWneRS multiple units (if home consists of more than
1. Property tax bills for both 2008 and 2009, one unit). If the property consists of more than
along with one unit, the applicant is only eligible for the
2. Proof of the amount of property taxes paid proportionate share of the reimbursement which
which may be either: relects the percentage of the property used as his
a. Copies of cancelled checks or receipts for or her principal residence.
both 2008 and 2009 showing the amount
moBIle Home oWneRS
of property taxes paid; or
1. A copy of the contract(s) or agree ment(s)
b. Copies of Form 1098 for both 2008 and for both 2008 and 2009 from the mobile home
2009 which you re ceived from your mort- park showing the amount of your site fees,
gage company showing the amount of
along with
property taxes which were paid out of your
escrow account. 2. Proof of the amount of site fees paid which
may be either:
Veriication Form. We realize that you may not be
able to locate your 2008 and 2009 property tax bills a. Copies of cancelled checks or receipts for
or proof of the amount of taxes paid. For your con- both 2008 and 2009 showing the amount
venience, we have included a form in this booklet of site fees paid; or
(Form PTR1A) which you may submit as proof of
the amount of property taxes due and paid.
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2009 Form PTR-1 Instructions

b. A signed statement from the mobile home at www.state.nj.us/treasury/taxation/
park management showing the amount of propfrez.shtml or call 1-800-323-4400
site fees paid for both 2008 and 2009. for updated information on beneit
amounts and payment information.
Veriication Form. In place of 1 and 2 above,
mobile home own ers may provide a completed Under New Jersey law, if you receive a property tax
Form PTR-1B. reimbursement that is larger than the amount for
which you are eligible, you will be required to repay
NO T E: If you choose to use Form PTR-1B, you any excess you received. The amount you owe can
must have Part II completed and certi- be deducted from your property tax reimbursement,
ied by the owner or manager of the income tax refund or credit, or homestead rebate
mobile home park as to the amount of before the payment is issued.
mobile home park site fees due and
paid for both 2008 and 2009. Be sure
Privacy Act Notification
to enclose the completed veriication
The Federal Privacy Act of 1974 requires an
form with your Form PTR-1 application.
agency requesting information from individu als to
inform them why the request is being made and
Deceased Residents
how the information is being used.
If a person met all the eligibility requirements for
2008 and 2009, but died before iling an appli ca Your social security number is used primarily to
tion, Form PTR1 should be iled by the surviving account for and give credit for tax pay ments. The
spouse/civil union partner, executor, or admin- Division of Taxation also uses social security num-
istrator. Print “Deceased” and the date of death bers in the administration and enforcement of all
above the dece dent’s name. Indicate on Line 2 the tax laws for which it is responsible. In addition,
marital status of the applicant(s) on December 31, the Division of Taxa tion is required by law to for-
2008, and indicate on Line 3 the marital/civil union ward an annual list to the Administrative Ofice of
status of the applicant(s) on December 31, 2009. the Courts con taining the names, addresses, and
In the area where you sign the application write social security numbers of individuals who ile a
“Filing as Surviving Spouse” or “Filing as Surviv- New Jersey tax return or property tax rebate appli-
ing Civil Union Partner,” if appropriate. A personal cation. This list will be used to avoid duplication of
representative iling the application must sign in his names on jury lists.
or her oficial capacity. Any reimburse ment check
will be issued to the surviving spouse/civil union Completing the Application
partner or estate.
name and Address
When a spouse/civil union partner dies prior to Place the peel-off label in the name and address
December 31, the marital/civil union status of the section at the top of the application. You will ind
survivor who does not remarry or enter into a new your preprinted name and address label inside the
civil union during that year is “Single.” He or she insert at the front of this booklet. Do not use the
must satisfy all the eligibility requirements (age mailing label if any of the information is inac-
or disability, income, residency) for that year as a curate. If the information on the preprinted label
single individual. is incorrect or if you did not receive a preprinted
label, print or type your name (last name irst),
Reimbursement Checks complete address, and zip code in the spaces pro-
For qualiied applicants who apply before May 1, vided. Be sure to include your spouse’s/civil union
2010, reimbursement checks will be sent on or be- partner’s name if your marital/civil union status as
fore July 15, 2010. Qualiied applicants who apply of December 31, 2009, was married/CU couple.
between May 1 and June 1, 2010, will be sent reim- Your reimbursement and next year’s application
bursement checks on or before September 1, 2010. will be sent to the address you provide.

NO T E: Beneits available under this program If your mailing address is different from the address
may be affected by State budgetary of the property for which the reim burse ment is
constraints. Please check our Web site
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                                                                             2009 Form PTR-1 Instructions

  being claimed, print or type the property address in     line 2 - 2008 marital/Civil Union 
the space provided on Line 9 of this application.
                                                             Status
                                                           Indicate your marital/civil union status on Decem-
Social Security number
If your marital/civil union status as of December 31,      ber 31, 2008. Fill in only one oval (). If you 
2009, was single, you must enter your social secu-         were married or in a civil union but living apart 
rity number in the space provided on the applica-          from your spouse/civil union partner, and you did 
tion, one digit in each box (). Your social security       not have access to or receive support from their 
num  ber is not printed on your name and   address           income, you are considered “Single” for purposes 
label. If your status as of     De  cem  ber 31, 2009, was of the property tax   reimbursement.
married/CU couple, you must report both appli-
cants’ numbers in the   order in which the names are       line 3 - 2009 marital/Civil Union 
listed on the ap  pli  cation. If you were married or in     Status
a civil union but living apart from your spouse/civil      Indicate your marital/civil union status on Decem-
union partner, and you did not have access to or           ber 31, 2009. Fill in only one oval (). If you 
receive support from their income, you are consid-         were married or in a civil union but living apart 
ered “Single” for purposes of the property tax reim-       from your spouse/civil union partner, and you did 
bursement and you should enter only your social            not have access to or receive support from their 
security number on the   application.                        income, you are considered “Single” for purposes 
                                                           of the property tax   reimbursement.
If you (or your spouse/civil union partner) do not 
have a social security number, ile Form SS5 with 
the   Social Security Administration to apply for a        line 4 - Age/Disability Status
                                                           Fill in the oval () at Line 4a to indicate your 
social security number. If you are not eligible for 
                                                           status as of Decem  ber 31, 2008, and at Line 4b 
a social   security number, you must ile Form W7 
                                                           to indicate your status on December 31, 2009, as 
with the Internal Revenue Service to obtain an 
individual taxpayer identiication number (ITIN). If          follows:
you   applied for but have not received an ITIN by         • If you or your spouse/civil union partner were 
the due date, enclose a copy of your Federal Form            65 or older on   December 31, 2008, or Decem-
W-7 application with Form PTR-1.                             ber 31, 2009, ill in the oval to the left of “Age 65 
                                                             or older.” 
County/municipality Code                                   •  If you and your spouse/civil union partner were 
Enter your four-digit county/municipality code, one 
                                                             under 65, and you (or your spouse/civil union 
digit in each box (), from the table on page 10. 
                                                             partner) were re  ceiv  ing Fed  eral Social Security 
This code identiies the county and municipality of           disability beneits on December 31, 2008, or 
your current residence. The county and municipal-            December 31, 2009, ill in the oval to the left of 
ity codes in these instructions are for Division of 
                                                               “Receiving Federal Social Security Disability 
Taxation purposes only.
                                                               Beneits.” 
NO T E: If the   local name of the place where             If you or your spouse/civil union partner did not 
        you live is not listed, enter the code             meet the age or disability requirement for both 
        for the municipality where the property            2008 and 2009, you are not eligible for the 
        taxes were paid on your dwelling. (Go              reimbursement and you should not ile this 
        to www.state.nj.us/infobank/locality.htm             application.
        for a listing of local names in the State 
        and the county and municipality in 
        which they are   located.)                         Residency Requirements  
                                                           (lines 5 and 6)
line 1 - Residency Status                                  line 5. Check “Yes” if you lived in New Jersey 
Fill in the oval ( ) to indicate whether you are           continuously since before January 1, 1999, as 
claiming the reimbursement as a “Homeowner” or               either a homeowner or a renter. If “No,” you are 
“Mobile Home Owner.” Fill in only one oval.                not eligible for a property tax reimbursement 
                                                           and you should not ile this application.
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2009 Form PTR-1 Instructions

line 6. Check “Yes” if you owned and lived in the or mobile home that you own) continuously since
home for which you are claiming the reimburse- before January 1, 2006. If “No,” you are not eli-
ment (or leased a site in a mobile home park in gible for a property tax reimbursement and you
New Jersey on which you placed a manufactured should not ile this application.

Important

If you did not satisfy all the requirements at lines 4, 5, and 6 for BoTH 2008 AnD 2009, you are not
eligible for the reimbursement. Do not ile the application.

Determining Income eligibility (lines 7 and 8)

2008 Total Income*

If your total 2008
income was… Then…

$70,000 or less You meet the income eligibility requirement for 2008. Continue completing the application.

Over $70,000 You are not eligible for the reimbursement and should not ile this application.

2009 Total Income*

If your total 2009
income was… Then…

$80,000 or less You meet the income eligibility requirement for 2009. Continue completing the application.

Over $80,000 You are not eligible for the reimbursement and should not ile this application.

* These income limits apply regardless of your marital/civil union status. If your status at Line 2, and/or
Line 3, Form PTR1, is married/CU couple, you must report the combined income of both spouses/CU partners
for that year.

Income Worksheet A - 2008 income when com pleting the worksheet. If your
List all the income you received in 2008. Add spouse/civil union partner died during 2008 and
the amounts on lines a through q. If your total your status on December 31, 2008, was “Single,”
2008 income was $70,000 or less, you meet the list only the income you yourself received (do not
income eligibility requirement for 2008. See chart include your deceased spouse’s/civil union part-
above. If you were married or in a civil union as ner’s income). Joint income must be apportioned
of December 31, 2008, you must combine your to relect the amount you received.
income with your spouse’s/civil union partner’s

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Form PTR-1A

Homeowners
Veriication of 2008 and 2009 Property Taxes
(Use blue or black ink. See instructions for completion on back.)
Part I — To Be Completed by Applicant (Part II to be completed by tax collector)
Social Security # – – Spouse’s/CU Partner’sSocial Security # – –
Name
Last Name, First Name, and Initial (Joint ilers enter irst name and initial of each Enter spouse’s/CU partner’s last name ONLY if different)
Address
Street City State Zip Code
Block Lot Qualiier
2008 2009
A. Did you own your principal residence with someone who was not your spouse/CU partner? Yes No Yes No
B. If yes, indicate the share (percentage) of property that you (and your spouse/CU partner) owned. % %
C. Does your principal residence have more than one unit? Yes No Yes No
D. If yes, indicate the share (percentage) of property used as your principal residence. % %

Part II — To Be Completed by Tax Collector
2008 Property Taxes 2009 Property Taxes
1. Total Amount Levied by Municipality (before 1. Total Amount Levied by Municipality (before
Deductions and/or Credits are subtracted) .......$ _________ Deductions and/or Credits are subtracted) .......$ _________

2. Total 2008 Taxes Paid 2. Total 2009 Taxes Paid
by Homeowner(s) by 6/1/09 ......$ _________ by Homeowner(s) by 6/1/10 ......$ _________

3. Senior Citizen’s Deduction ........$ _________ 3. Senior Citizen’s Deduction ........$ _________

4. Veteran’s Deduction ..................$ _________ 4. Veteran’s Deduction ..................$ _________

5. REAP Credit ..............................$ _________ 5. REAP Credit ..............................$ _________

6. Total Deductions and Credits 6. Total Deductions and Credits
(Add Lines 2, 3, 4, and 5) ..................................$ _________(Add Lines 2, 3, 4, and 5) ..................................$ _________
If line 6 is equal to line 1, complete line 7 If line 6 is equal to line 1, complete line 7
7. Enter amount from Line 6. If applicant 7. Enter amount from Line 6. If applicant
answered “Yes” to Questions A and/or answered “Yes” to Questions A and/or
C above, the amount on Line 7 must be C above, the amount on Line 7 must be
apportioned. See instructions on back. .............$ _________ apportioned. See instructions on back. .............$ _________

Applicant enters this amount on line 14, Form PTR-1 Applicant enters this amount on line 13, Form PTR-1
I certify that I am the local tax collector of , where the above property is
located. I further certify that the above-stated amounts of property taxes due and paid for calendar years 2008 and 2009 are true and
accurate to the best of my knowledge. I have placed my stamp below for veriication.

(Name)

(Title)

(If you complete this form, be sure to enclose it with your Form PTR-1 application.)

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Form PTR-1A – Instructions

Part I – To Be Completed by Applicant Part II – To Be Completed by Tax Collector
Social Security number. If your marital/civil union status Enter the appropriate amounts for calendar years 2008 and
as of De cember 31, 2009, was single, enter only your social 2009 as follows:
security number in the space provided on Form PTR1A.
line 1. Enter the amount of property taxes levied by the
If your status as of December 31, 2009, was married/CU
municipality before any deductions and/or credits are sub-
couple, you must report both applicants’ numbers in the or-
tracted (e.g., senior citizen’s deduction).
der in which the names are listed on the application. If you
were married or in a civil union but living apart from your line 2. Enter the total amount of property taxes paid by, or
spouse/civil union partner, and you did not have access to on behalf of, the homeowner(s). Enter only amounts actu-
or receive support from their income, you are considered ally due for each year provided 2008 taxes were paid by
“Single” for purposes of the property tax reimbursement and June 1, 2009, and 2009 taxes were paid by June 1, 2010.
you should enter only your social security number on Form
PTR1A. line 3. Enter the amount of any senior citizen’s deduction
the homeowner(s) received for each calendar year.
name and Address. Print or type your name (last name
irst) and complete address of the property for which you are line 4. Enter the amount of any veteran’s deduction the
claiming the reimbursement in the spaces provided. Also in- homeowner(s) received for each calendar year.
clude your spouse’s/civil union partner’s name if iling jointly.line 5. Enter the amount of any Regional Eficiency Aid
Block/lot/Qualiier. Enter the block and lot numbers of the Program (REAP) credit the homeowner(s) received for each
principal residence for which you are claiming the reimburse- calendar year.
ment in the spaces provided. Include qualiier if applicable. Add Lines 2, 3, 4, and 5 and enter the total on Line 6.
line 6.
(Only condominiums may have qualiiers assigned to them.) Compare Lines 1 and 6 for each calendar year.
A. multiple owners. Check “Yes” if you owned your • If Line 6 is equal to Line 1 for both years, complete the
principal residence with someone else (other than balance of Form PTR1A.
your spouse/civil union partner) — even if the other • If Line 6 is not equal to Line 1 for both years, the ap-
owner(s) did not reside in the home. For example, you
plicant is not eligible for a property tax reimbursement.
and your sister own the home you live in. If you (and
Do not complete the balance of Form PTR-1A.
your spouse/civil union partner) were the sole owner(s),
check “No.” line 7. If the applicant answered “No” to the questions at
B. Percentage of ownership. If you answered “Yes” at both Line A and Line C, enter the amount of property taxes
Line A, enter the share (percentage) of the property that from Line 6.
you (and your spouse/civil union partner) owned. For If the applicant answered “Yes” at either Line A or Line C,
example, if you and your spouse/civil union partner own the amount of property taxes to be entered on Line 7 must
your principal residence equally with your daughter, you be apportioned. If title to the property is held by the eligible
and your spouse/civil union partner own one-half of the applicant with others as tenants in common or joint ten-
property and must enter 50% as your share of owner- ants (except in the case of husband and wife or civil union
ship. The shares of ownership of the property are con- partners), or if the property consists of more than one unit,
sidered to be held equally by all owners. If the shares of
the applicant is only eligible for the proportionate share of the
ownership are not equal, you must provide documenta-
reimbursement which relects the percentage of ownership or
tion as to the percentage of ownership.
the percentage of occupancy.
C. multi-Unit Properties. Check “Yes” if your principal
multiple owners. If the applicant answered “Yes” at
residence consists of more than one unit. For example,
Part I, Line A, multiply the amount of property taxes on
you own a property which consists of four residential
units and you occupy one of the units as your principal Line 6 by the percentage of ownership shown at Part I,
residence. If your principal residence consisted of only Line B, and enter the result on Line 7.
one unit, check “No.” multi-Unit Properties. If the applicant answered “Yes” at
NO T E: Residents of co-ops and continuing care retire- Part I, Line C, multiply the amount of property taxes on
ment facilities are not considered to be living in multi- Line 6 by the percentage of occupancy shown at Part I,
unit dwellings and should check “No.” Line D, and enter the result on Line 7.
D. Percentage of occupancy. If you answered “Yes” at If the applicant answered “Yes” to the questions at both
Line C, enter the share (percentage) of the property Lines A and C in the same year, multiply the amount of
used as your principal residence. For example, if you property taxes on Line 6 by the percentage of occupancy
and your spouse/civil union partner own a duplex and shown at Part I, Line D, and enter the result on Line 7.
live in one-half of the property and your daughter lives
Certiication. Complete the certiication portion of Form
in the other half, you must enter 50% as your share of
PTR1A. Sign the certiication and place the authorization
occupancy.
stamp in the space provided. (Use blue or black ink.)

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Form PTR-1B mobile Home owners
Veriication of 2008 and 2009 mobile Home Park Site Fees
(Applicant completes Parts I and III. mobile home park owner or manager completes Part II.
Use blue or black ink. See instructions for completion on back.)

Part I — To Be Completed by Applicant
– – – –
Social Security # Spouse’s/CU Partner’s Social Security #
Name
Last Name, First Name, and Initial (Joint ilers enter irst name and initial of each Enter spouse’s/CU partner’s last name ONLY if different)
Address
Street City State Zip Code

Mobile Home Park Site #
2008 2009
A. Did someone other than your spouse/CU partner occupy your mobile
home and share site fees with you? If you (and your spouse/CU partner) Yes No Yes No
were the sole occupant(s), check “No.”
B. Indicate the share (percentage) of the site fees that you and your
spouse/CU partner paid. If you (and your spouse/CU partner)
were the sole occupant(s), enter 100%. % %

Part II — To Be Completed by mobile Home Park owner or manager
Column A — 2008 Site Fees Column B — 2009 Site Fees
(Do not include municipal service fees or other charges) (Do not include municipal service fees or other charges)
1. Total site fees due for calendar year 2008 under 1. Total site fees due for calendar year 2009 under
agreement with mobile home park. ....................$ agreement with mobile home park. ....................$

2. Total site fees paid by resident(s) for calendar 2. Total site fees paid by resident(s) for calendar
year 2008 only. ...................................................$ year 2009 only. ...................................................$
If line 2 is less than line 1, the applicant is not eligible If line 2 is less than line 1, the applicant is not eligible
for a reimbursement. Do not complete the certiication. for a reimbursement. Do not complete the certiication.

I certify that I am the owner or manager of , where the above
mobile home site is located. I further certify that the above-stated amounts of site fees due and paid for calendar years
2008 and 2009 are true and accurate to the best of my knowledge.

(Name) (Title) (Phone)

Part III — To Be Completed by Applicant (AFTeR Part II has been completed by mobile home park owner or manager)
Column A — 2008 Column B — 2009
3. Total site fees paid by all residents living at this 3. Total site fees paid by all residents living at this
address. (Enter amount from Part II, Line 2, address. (Enter amount from Part II, Line 2,
Column A) .........................................................$ __________ Column B) .........................................................$ __________
4. Share (percentage) of site fees that you (and 4. Share (percentage) of site fees that you (and
your spouse/CU partner) paid in 2008. (Enter your spouse/CU partner) paid in 2009. (Enter
percentage from Part I, Line B as a decimal. percentage from Part I, Line B as a decimal.
For example, if the share is 50%, enter 0.50. For example, if the share is 50%, enter 0.50.
If 100%, enter 1.00) .......................................... __________ If 100%, enter 1.00) ..........................................  __________
5. Total site fees paid by you (and your spouse/ 5. Total site fees paid by you (and your spouse/
CU partner) (Line 3  Line 4) ...........................$ __________ CU partner) (Line 3  Line 4) ...........................$ __________
6. Total property taxes paid by you (and your 6. Total property taxes paid by you (and your
spouse/CU partner) (Line 5  0.18). enter spouse/CU partner) (Line 5  0.18). enter
this amount on line 14, Form PTR-1 ............ $ __________ this amount on line 13, Form PTR-1 ............ $ __________

(If you complete this form, be sure to enclose it with your Form PTR-1 application.)

- 10 -

Form PTR-1B – Instructions

Part I – To Be Completed by Applicant
Social Security number. If your marital/civil union sta- mobile Home Park Site number. Enter the mobile home
tus as of De cember 31, 2009, was single, you must enter park site number of the principal residence for which you
your social security number in the space provided on Form are claiming the reimbursement in the space provided.
PTR1B. If your status as of December 31, 2009, was mar-
A. multiple occupants. Check “Yes” only if you occupied
ried/CU couple, you must report both applicants’ numbers
your mobile home with someone else (other than your
in the order in which the names are listed on the applica-
spouse/civil union partner) and shared mobile home
tion. If you were married or in a civil union but living apart
site fees with them. For example, you live in your mo-
from your spouse/civil union partner, and you did not have
bile home with your sister. If you (and your spouse/civil
access to or receive support from their income, you are con-
union partner) were the sole occupant(s), check “No.”
sidered “Single” for purposes of the property tax reimburse-
ment and you should enter only your social security number B. Percentage of Site Fees Paid. Enter the share (per-
on Form PTR-1B. centage) of the site fees that you (and your spouse/civil
union partner) paid. For example, if you and your sister
name and Address. Print or type your name (last name
live in your mobile home and you both pay one-half
irst) and complete address of the property for which you
of the site fees, you must enter 50% as your share. If
are claiming the reimbursement in the spaces provided.
you (and your spouse/civil union partner) were the sole
Also include your spouse’s/civil union partner’s name if iling
occupant(s), enter 100%.
jointly.

Part II – To Be Completed by mobile Home Park owner or manager

Enter the appropriate amounts for calendar years Compare Lines 1 and 2 for each calendar year.
2008 and 2009 as follows:
• If Line 2 is equal to Line 1 for both years, complete the
line 1. Enter the amount of site fees due under the mobile certiication portion of Form PTR1B.
home park agreement entered into with the resident(s).
•
line 2. Enter the total amount of mobile home site fees paid If Line 2 is less than Line 1 for either or both years, the
applicant is not eligible for a property tax reimburse-
by, or on behalf of, the resident(s). Enter only amounts ac-
ment. Do not complete the certiication portion of
tually due and paid for each calendar year.
Form PTR-1B.

Certiication. Complete the certiication portion of Form
PTR-1B.

Part III – To Be Completed by Applicant

line 3 - Total Site Fees Paid. Enter the total site fees you and your spouse/civil union partner were the sole occu-
paid for each calendar year by all residents who lived in pant(s), enter 1.00.
the mobile home for which you are claiming a property tax
reimbursement. (Enter amount from Part II, Line 2.) line 5 - Total Site Fees Paid by Applicant. Multiply the
amount on Line 3 by the decimal on Line 4.
line 4 - Percentage of Site Fees Paid. Enter your share
(percentage) of site fees paid from Part I, Line B for each line 6 - Total Property Taxes Paid by Applicant. Multiply
calendar year. Enter this number as a decimal. For ex- the amount of site fees on Line 5 by 18% (0.18) and enter
ample, if you lived in your mobile home with your sister and the result in the box at Line 6.
you both paid 50% of the site fees, enter 0.50 on Line 4. If

- 11 -

                                 Form PTR-1B – Instructions2009 Form PTR-1 Instructions

line 7 - 2008 Total Income                            line 11a - multiple owners
If you meet the income eligibility requirement,       Homeowners. Check “Yes” only if you owned 
  enter the amount of your 2008 Total Income from     your principal residence with someone else (other 
Income Worksheet A, Line r and continue with          than your spouse/civil union partner) — even if 
  Income Worksheet B.                                 the other owner(s) did not reside in the home. For 
                                                      example, you and your sister own the home you 
Income Worksheet B - 2009                             live in. If you (and your spouse/civil union partner) 
List all the income you received in 2009. Add the     were the sole own  er(s), check “No.”
amounts on lines a through q. If your total 2009 
income was $80,000 or less, you meet the in-          mobile Home owners. If you occupied your mo-
come eligibility requirement for 2009. See chart      bile home with someone other than your spouse/
on page 6. If you were married or in a civil union    civil union partner and shared site fees with them, 
as of December 31, 2009, you must combine your        check “Yes.” If you (and your spouse/civil union 
income with your spouse’s/civil union partner’s       partner) were the sole occupant(s), check “No.”
income when completing the worksheet. If your 
spouse/civil union partner died during 2009 and       line 11b - Percentage of ownership
                                                      Homeowners. If you answered “Yes” at Line 11a, 
your status on December 31, 2009, was “Single,” 
                                                      enter the share (percentage) of the property 
list only the income you yourself received (do not 
                                                      owned by you (and your spouse/civil union part-
include your deceased spouse’s/civil union part-
                                                      ner). For exam  ple, if you and your spouse/civil 
ner’s income). Joint income must be apportioned 
                                                      union partner own your principal residence equally 
to relect the amount you received.
                                                      with your daughter, you and your spouse/civil 
line 8 - 2009 Total Income                            union partner own one-half of the property and 
If you meet the income eligibility requirement,       must enter 50% on Line 11b of your application. If 
  enter the amount of your 2009 Total Income from     your daughter is also eligible, she must ile a sepa-
Income Worksheet B, Line r.                           rate property tax reimbursement   application. 

                                                      mobile Home owners. If you answered “Yes” at 
line 9 - Address
                                                      Line 11a, enter the share (percentage) of site fees 
Enter the street address and municipality of the 
                                                      that you (and your spouse/civil union partner) paid. 
New Jersey residence for which you are claiming 
the reimbursement if it is different from your mail-
                                                      line 12a - multi-Unit Properties
ing   address.
                                                      Check “Yes” if your principal residence consisted 
                                                      of more than one unit. For example, you own a 
line 10 - Block and lot numbers
                                                      property which consists of four residential units 
Homeowners enter the Block and Lot Numbers 
of the residence for which the reimbursement is       and you occupy one of the units as your principal 
  being claimed. (If a condominium, also in    clude  residence. If your principal residence consisted of 
qualiier.) You may obtain this information from       only one unit, check “No.” 
your current property tax bill or from your local tax NO T E: Residents of co-ops and continu-
assessor. (mobile Home owners will not have a                 ing care retirement facilities are not 
block or lot number.)                                           con  sidered to be living in multi-unit 
                                                              dwell  ings and should check “no.”
When you enter the Block and Lot Numbers on 
your application, treat the space between the ifth 
                                                      line 12b - Percentage of occupancy
and sixth boxes as a decimal point and enter your 
                                                      If you answered “Yes” at Line 12a, enter the share 
numbers accordingly (e.g., if the Block Number is 
                                                      (percentage) of the property that you (and your 
35.6, enter “35” in the boxes immediately to the 
                                                      spouse/civil union partner) used as your principal 
left of the space, and enter “6” in the box immedi-
                                                      residence. For example, if you and your spouse/
ately to the right of the space. 
                                                      civil union partner own a duplex and live in one-
                                                      half of the property and your daughter lives in the 
                                                      other half, you must   enter 50% on Line 12b.

                                                                                           Page 7

- 12 -

2009 Form PTR-1 Instructions

2009 and 2008 Property Taxes                               documentation with your application showing your 
                                                         percentage of ownership. For   exam  ple, you and 
(lines 13 and 14)
                                                         your sister (who lives in another state) are co
HomeoWneRS                                                 owners of a home on which you pay all the proper-
Enter your total property taxes due and paid on          ty taxes. If the 2009 property taxes totaled $6,000 
your principal residence in New Jersey for 2009 on       and the 2008 property taxes totaled $5,000, you 
Line 13, and for 2008 on Line 14. (If you received       must indicate at Line 11b that you owned 50% of 
a senior citi  zen’s deduction, vet  eran’s   deduction, the property, and you must   enter $3,000 ($6,000 
and/or a Regional   Eficiency Aid Program (REAP)          50%) on Line 13 and $2,500 ($5,000  50%) on 
credit for 2008 or 2009, enter the amount of             Line 14. You are only eligible for a proportionate 
property taxes actually due and paid before the          share of the reimbursement based on your per-
deduc  tion(s) and/or credit were subtracted.) If you    centage of ownership in the property. Your sister 
  enclose Form PTR-1A, you must enter the prop-          is not eligible for a reimbursement for this home 
erty tax amounts for 2008 and 2009 from Part II,         because she does not live there.
Line 7.
                                                         multiple Units. If your home consisted of more 
Enter dollars and cents, one digit in each box (      ). than one unit, enter for each year the proportion-
Do not use dollar signs or dashes. If you did not        ate share of the property taxes for the unit you oc-
pay the full amount of 2009 property taxes due by        cupied as your principal residence. For example, if 
June 1, 2010, or if you did not pay the full amount      the 2009 property taxes for your four-unit property 
of 2008 property taxes due by June 1, 2009, you          totaled $4,000 and the 2008 property taxes totaled 
are not eligible for the   reimbursement.                $3,800 and you indicated at Line 12b that you 
                                                         occu  pied 25% of the property (one unit), you must 
NO T E: 
                                                         enter $1,000 ($4,000  25%) on Line 13 and $950 
•  If you (or your spouse/civil union partner)                 
                                                         ($3,800   25%) on Line 14. You are only eligible 
 are a totally and permanently disabled vet-
                                                         for a proportionate share of the reimbursement 
 eran who received a 100% exemption from 
                                                         based on the portion of the property that you occu-
 local property taxes in 2008 or 2009, you 
                                                         pied as your principal residence, even if you paid 
 are not eligible for a property tax reimburse-
                                                         all of the property taxes.
 ment, even if a portion of the dwelling was 
 rented to a tenant and property taxes were 
                                                         multi-Unit Property With multiple owners. If 
 paid on the rented portion.
                                                         you answered “Yes” at both Lines 11a and 12a for 
•  If you made P.I.l.o.T. (Payments-in-lieu-of-          2008 or 2009, use the percentage of occupancy 
 Tax) payments to your municipality during               on Line 12b to calculate your proportionate share 
 2008 or 2009, these payments are not con-               of property taxes. 
 sidered property taxes for purposes of the 
 property tax reimbursement.                             moBIle Home oWneRS
                                                         Enter your property taxes due and paid on your 
Residents of cooperative dwelling units and 
                                                         principal residence in New Jersey for 2009 on 
continuing care retirement facilities must obtain 
                                                         Line 13, and for 2008 on Line 14. (For mobile 
a statement from their management indicating 
                                                         home owners, property taxes are 18% of the an-
their share of property taxes paid for the residen-
                                                         nual site fees due and paid to the owner of the 
tial unit they occupy.                                   mobile home park.) If you lived with someone 
                                                         (other than your spouse/civil union partner) and 
multiple owners. If you owned your home with 
                                                         shared the site fees with them, use the percentage 
someone other than your spouse/civil union part-
                                                         entered on Line 11b to calculate the proportion-
ner, enter for each year the proportionate share of 
                                                         ate share of the site fees paid by you (and your 
the prop    erty taxes for your percentage of owner-
                                                         spouse/civil union partner). Multiply the amount 
ship listed at Line 11b. The shares of ownership 
                                                         of site fees for each year by 18% (0.18) and en-
of the prop  erty are   considered to be held equally 
                                                         ter the result in the boxes at Lines 13 and 14. If 
by all owners. If the shares of ownership are 
                                                         you enclose Form   PTR-1B, you must enter on 
not equal, enclose a copy of your deed or other 

Page 8

- 13 -

2009 Form PTR-1 Instructions

Lines 13 and 14 the property tax amounts for 2008 Under New Jersey law, if you receive a property tax
and 2009 from Part III, Line 6. reimbursement that is larger than the amount for
which you are eligible, you will be required to repay
Enter dollars and cents, one digit in each box ( ). any excess you received. The amount you owe can
Do not use dollar signs or dashes. If you did not be deducted from your property tax reimbursement,
pay the full amount of site fees due for 2009 by income tax refund or credit, or homestead rebate
December 31, 2009, or the full amount of site fees before the payment is issued.
due for 2008 by December 31, 2008, you are not
eligible for the reimbursement.
Signatures
Sign and date your Property Tax Reimburse ment
Important Application in ink. If your 2009 marital/civil union
You must enclose veriication of 2008 and status is married/CU couple, both of you must sign
2009 property taxes (or mobile home park the appli cation. The signatures on the application
site fees) due and paid with Form PTR-1. See you ile must be original; photocopied signatures
page 3 for acceptable forms of proof. are not acceptable.

Tax Preparers. Anyone who prepares an ap-
line 15 - Reimbursement Amount plication for a fee must sign the application as a
Subtract Line 14 from Line 13 and enter the result “Paid Preparer” and enter his or her so cial secu-
on Line 15. Enter dollars and cents, one digit in rity number or Federal preparer tax identiication
each box (). Do not use dollars signs or dashes. number. Include the company or corporation name
This is the amount of your 2009 property tax and Federal identiication number, if applicable.
reimbursement. A tax preparer who fails to sign the application
or provide a tax identii cation number may incur
If the amount on Line 15 is zero or less, you are a $25 penalty for each omission. Someone who
not eligible for a property tax reimbursement prepares your application but does not charge you
and you should not ile this application. should not sign your application.
The total amount of all property tax relief beneits
you receive for 2009 (property tax reimbursement, Where to Send Your
homestead rebate, property tax deduction for Ap plication
senior citizens/disabled persons, and property tax When you have completed and signed your appli-
deduction for veterans) cannot exceed the total cation, use the envelope provided in the booklet to
amount of property taxes or rent/site fees consti- mail the application and supporting documentation
tuting property taxes paid for 2009 on your prin- to:
cipal residence in New Jersey. (For this purpose,
18% of rent/site fees paid during the year is con- NJ Division of Taxation
Revenue Processing Center
sidered property taxes.) This limitation may affect
the amount of your property tax reimbursement. Property Tax Reimbursement
PO Box 635
NO T E: Beneits available under this program Trenton, NJ 086460635
may be affected by State budgetary
constraints. Please check our Web site For information or help in completing your applica-
at www.state.nj.us/treasury/taxation/ tion, call the Property Tax Reimburse ment Hotline
propfrez.shtml or call 1-800-323-4400 at 18008826597 to speak to a Division of Taxa
for updated information on beneit tion representative. Representatives are available
amounts and payment information. Monday through Friday, 8:30 a.m. to 4:30 p.m.
(except holidays).

Page 9

- 14 -

                             2009 County/municipality Codes
Enter the appropriate four-digit number in the boxes below the social security number boxes on Form PTR-1. These codes 
are for Division of Taxation purposes only. If the place where you live is not listed, see instructions on page 5.

municipality            Code municipality            Code municipality                                            Code

ATlAnTIC CoUnTY              Hasbrouck Heights Bor.  0225 Bordentown Township                                     0304
Absecon City            0101 Haworth Borough         0226 Burlington City                                         0305
Atlantic City           0102 Hillsdale Borough       0227 Burlington Township                                     0306
Brigantine City         0103 Ho Ho Kus Borough       0228 Chesterield Township                                    0307
Buena Borough           0104 Leonia Borough          0229 Cinnaminson Township                                    0308
Buena Vista Township    0105 Little Ferry Borough    0230 Delanco Township                                        0309
Corbin City             0106 Lodi Borough            0231 Delran Township                                         0310
Egg Harbor City         0107 Lyndhurst Township      0232 Eastampton Township                                     0311
Egg Harbor Township     0108 Mahwah Township         0233 Edgewater Park Township                                 0312
Estell Manor City       0109 Maywood Borough         0234
                                                          Evesham Township                                        0313
Folsom Borough          0110 Midland Park Borough    0235
                                                          Fieldsboro Borough                                      0314
Galloway Township       0111 Montvale Borough        0236
                                                          Florence Township                                       0315
Hamilton Township       0112 Moonachie Borough       0237
                                                          Hainesport Township                                     0316
Hammonton Town          0113 New Milford Borough     0238
                                                          Lumberton Township                                      0317
Linwood City            0114 North Arlington Borough 0239
                                                          Mansield Township                                       0318
Longport Borough        0115 Northvale Borough       0240
Margate City            0116 Norwood Borough         0241 Maple Shade Township                                    0319
Mullica Township        0117 Oakland Borough         0242 Medford Township                                        0320
Northield City          0118 Old Tappan Borough      0243 Medford Lakes Borough                                   0321
Pleasantville City      0119 Oradell Borough         0244 Moorestown Township                                     0322
Port Republic City      0120 Palisades Park Borough  0245 Mount Holly Township                                    0323
Somers Point City       0121 Paramus Borough         0246 Mount Laurel Township                                   0324
Ventnor City            0122 Park Ridge Borough      0247 New Hanover Township                                    0325
Weymouth Township       0123 Ramsey Borough          0248 North Hanover Township                                  0326
                             Ridgeield Borough       0249 Palmyra Borough                                         0327
BeRGen CoUnTY                Ridgeield Park Village  0250 Pemberton Borough                                       0328
Allendale Borough       0201 Ridgewood Village       0251 Pemberton Township                                      0329
Alpine Borough          0202 River Edge Borough      0252 Riverside Township                                      0330
Bergenield Borough      0203 River Vale Township     0253 Riverton Borough                                        0331
Bogota Borough          0204 Rochelle Park Township  0254 Shamong Township                                        0332
Carlstadt Borough       0205 Rockleigh Borough       0255 Southampton Township                                    0333
Cliffside Park Borough  0206 Rutherford Borough      0256 Springield Township                                     0334
Closter Borough         0207 Saddle Brook Township   0257 Tabernacle Township                                     0335
Cresskill Borough       0208 Saddle River Borough    0258 Washington Township                                     0336
                             South Hackensack Twp.   0259
Demarest Borough        0209                              Westampton Township                                     0337
                             Teaneck Township        0260
Dumont Borough          0210                              Willingboro Township                                    0338
                             Tenaly Borough          0261
East Rutherford Borough 0212                              Woodland Township                                       0339
                             Teterboro Borough       0262
Edgewater Borough       0213                              Wrightstown Borough                                     0340
                             Upper Saddle River Bor. 0263
Elmwood Park Borough    0211
                             Waldwick Borough        0264
Emerson Borough         0214                              CAmDen CoUnTY 
                             Wallington Borough      0265
                                                          Audubon Borough                                         0401
Englewood City          0215 Washington Township     0266
Englewood Cliffs Boro   0216 Westwood Borough        0267 Audubon Park Borough                                    0402
Fair Lawn Borough       0217 Woodcliff Lake Borough  0268 Barrington Borough                                      0403
Fairview Borough        0218 Wood-Ridge Borough      0269 Bellmawr Borough                                        0404
Fort Lee Borough        0219 Wyckoff Township        0270 Berlin Borough                                          0405
Franklin Lakes Borough  0220                              Berlin Township                                         0406
Garield City            0221 BURlInGTon CoUnTY            Brooklawn Borough                                       0407
Glen Rock Borough       0222 Bass River Township     0301 Camden City                                             0408
Hackensack City         0223 Beverly City            0302 Cherry Hill Township                                    0409
Harrington Park Borough 0224 Bordentown City         0303 Chesilhurst Borough                                     0410

Page 10

- 15 -

                            2009 County/municipality Codes
Enter the appropriate four-digit number in the boxes below the social security number boxes on Form PTR-1. These codes 
are for Division of Taxation purposes only. If the place where you live is not listed, see instructions on page 5.

municipality           Code municipality              Code municipality                                           Code

Clementon Borough      0411 Fairield Township         0605 South Harrison Township                                0816
Collingswood Borough   0412 Greenwich Township        0606 Swedesboro Borough                                     0817
Gibbsboro Borough      0413 Hopewell Township         0607 Washington Township                                    0818
Gloucester City        0414 Lawrence Township         0608 Wenonah Borough                                        0819
Gloucester Township    0415 Maurice River Township    0609 West Deptford Township                                 0820
Haddon Township        0416 Millville City            0610 Westville Borough                                      0821
Haddonield Borough     0417 Shiloh Borough            0611 Woodbury City                                          0822
Haddon Heights Borough 0418 Stow Creek Township       0612 Woodbury Heights Bor.                                  0823
HiNella Borough       0419 Upper Deerield Twp.       0613 Woolwich Township                                      0824
Laurel Springs Borough 0420 Vineland City             0614
Lawnside Borough       0421                                HUDSon CoUnTY
Lindenwold Borough     0422 eSSeX CoUnTY                   Bayonne City                                           0901
Magnolia Borough       0423 Belleville Township       0701 East Newark Borough                                    0902
Merchantville Borough  0424 Bloomield Township        0702 Guttenberg Town                                        0903
Mount Ephraim Borough  0425 Caldwell Borough Twp.     0703 Harrison Town                                          0904
Oaklyn Borough         0426 Cedar Grove Township      0704 Hoboken City                                           0905
Pennsauken Township    0427 East Orange City          0705 Jersey City                                            0906
Pine Hill Borough      0428 Essex Fells Twp.          0706 Kearny Town                                            0907
Pine Valley Borough    0429 Fairield Township         0707 North Bergen Township                                  0908
Runnemede Borough      0430 Glen Ridge Borough Twp.   0708 Secaucus Town                                          0909
Somerdale Borough      0431 Irvington Township        0709 Union City                                             0910
Stratford Borough      0432 Livingston Township       0710 Weehawken Township                                     0911
Tavistock Borough      0433 Maplewood Township        0711 West New York Town                                     0912
Voorhees Township      0434 Millburn Township         0712
Waterford Township     0435 Montclair Township        0713 HUnTeRDon CoUnTY
Winslow Township       0436 Newark City               0714 Alexandria Township                                    1001
Woodlynne Borough      0437 North Caldwell Borough    0715 Bethlehem Township                                     1002
                            Nutley Township           0716 Bloomsbury Borough                                     1003
CAPe mAY CoUnTY             Orange City               0717 Califon Borough                                        1004
Avalon Borough         0501 Roseland Borough          0718 Clinton Town                                           1005
Cape May City          0502 South Orange Village Twp. 0719 Clinton Township                                       1006
Cape May Point Borough 0503 Verona Township           0720 Delaware Township                                      1007
Dennis Township        0504 West Caldwell Township    0721 East Amwell Township                                   1008
Lower Township         0505 West Orange Township      0722 Flemington Borough                                     1009
Middle Township        0506                                Franklin Township                                      1010
North Wildwood City    0507 GloUCeSTeR CoUnTY              Frenchtown Borough                                     1011
Ocean City             0508 Clayton Borough           0801 Glen Gardner Borough                                   1012
Sea Isle City          0509 Deptford Township         0802 Hampton Borough                                        1013
Stone Harbor Borough   0510 East Greenwich Township   0803 High Bridge Borough                                    1014
Upper Township         0511 Elk Township              0804 Holland Township                                       1015
West Cape May Borough  0512 Franklin Township         0805 Kingwood Township                                      1016
West Wildwood Borough  0513 Glassboro Borough         0806 Lambertville City                                      1017
Wildwood City          0514 Greenwich Township        0807 Lebanon Borough                                        1018
Wildwood Crest Borough 0515 Harrison Township         0808 Lebanon Township                                       1019
Woodbine Borough       0516 Logan Township            0809 Milford Borough                                        1020
                            Mantua Township           0810 Raritan Township                                       1021
CUmBeRlAnD CoUnTY           Monroe Township           0811 Readington Township                                    1022
Bridgeton City         0601 National Park Borough     0812 Stockton Borough                                       1023
Commercial Township    0602 Newield Borough           0813 Tewksbury Township                                     1024
Deerield Township      0603 Paulsboro Borough         0814 Union Township                                         1025
Downe Township         0604 Pitman Borough            0815 West Amwell Township                                   1026

                                                                                                                  Page 11

- 16 -

                             2009 County/municipality Codes
Enter the appropriate four-digit number in the boxes below the social security number boxes on Form PTR-1. These codes 
are for Division of Taxation purposes only. If the place where you live is not listed, see instructions on page 5.

municipality            Code municipality             Code municipality                                           Code

meRCeR CoUnTY                Brielle Borough          1309 Chatham Township                                       1405
East Windsor Township   1101 Colts Neck Township      1310 Chester Borough                                        1406
Ewing Township          1102 Deal Borough             1311 Chester Township                                       1407
Hamilton Township       1103 Eatontown Borough        1312 Denville Township                                      1408
Hightstown Borough      1104 Englishtown Borough      1313 Dover Town                                             1409
Hopewell Borough        1105 Fair Haven Borough       1314 East Hanover Township                                  1410
Hopewell Township       1106 Farmingdale Borough      1315 Florham Park Borough                                   1411
Lawrence Township       1107 Freehold Borough         1316 Hanover Township                                       1412
Pennington Borough      1108 Freehold Township        1317 Harding Township                                       1413
Princeton Borough       1109 Hazlet Township          1318 Jefferson Township                                     1414
Princeton Township      1110 Highlands Borough        1319 Kinnelon Borough                                       1415
Robbinsville Township   1112 Holmdel Township         1320 Lincoln Park Borough                                   1416
Trenton City            1111 Howell Township          1321 Long Hill Township                                     1430
West Windsor Township   1113 Interlaken Borough       1322 Madison Borough                                        1417
                             Keansburg Borough        1323 Mendham Borough                                        1418
mIDDleSeX CoUnTY             Keyport Borough          1324 Mendham Township                                       1419
Carteret Borough        1201 Lake Como Borough        1346 Mine Hill Township                                     1420
Cranbury Township       1202 Little Silver Borough    1325 Montville Township                                     1421
Dunellen Borough        1203 Loch Arbour Village      1326 Morris Plains Borough                                  1423
East Brunswick Township 1204 Long Branch City         1327 Morris Township                                        1422
Edison Township         1205 Manalapan Township       1328 Morristown Town                                        1424
Helmetta Borough        1206 Manasquan Borough        1329 Mountain Lakes Borough                                 1425
Highland Park Borough   1207 Marlboro Township        1330 Mt. Arlington Borough                                  1426
Jamesburg Borough       1208 Matawan Borough          1331 Mt. Olive Township                                     1427
Metuchen Borough        1209 Middletown Township      1332 Netcong Borough                                        1428
Middlesex Borough       1210 Millstone Township       1333 ParsippanyTroy Hills Twp.                             1429
Milltown Borough        1211 Monmouth Beach Borough   1334 Pequannock Township                                    1431
Monroe Township         1212 Neptune City Borough     1336 Randolph Township                                      1432
New Brunswick City      1213 Neptune Township         1335 Riverdale Borough                                      1433
North Brunswick Twp.    1214 Ocean Township           1337 Rockaway Borough                                       1434
Old Bridge Township     1215 Oceanport Borough        1338 Rockaway Township                                      1435
Perth Amboy City        1216 Red Bank Borough         1339 Roxbury Township                                       1436
Piscataway Township     1217 Roosevelt Borough        1340 Victory Gardens Borough                                1437
Plainsboro Township     1218 Rumson Borough           1341 Washington Township                                    1438
Sayreville Borough      1219 Sea Bright Borough       1342 Wharton Borough                                        1439
South Amboy City        1220 Sea Girt Borough         1343
South Brunswick Twp.    1221 Shrewsbury Borough       1344 oCeAn CoUnTY 
South Plainield Bor.    1222 Shrewsbury Township      1345 Barnegat Township                                      1501
South River Borough     1223 Spring Lake Borough      1347 Barnegat Light Borough                                 1502
Spotswood Borough       1224 Spring Lake Heights Bor. 1348 Bay Head Borough                                       1503
Woodbridge Township     1225 Tinton Falls Borough     1349 Beach Haven Borough                                    1504
                             Union Beach Borough      1350 Beachwood Borough                                      1505
monmoUTH CoUnTY              Upper Freehold Township  1351 Berkeley Township                                      1506
Aberdeen Township       1301 Wall Township            1352 Brick Township                                         1507
Allenhurst Borough      1302 West Long Branch Boro    1353 Eagleswood Township                                    1509
Allentown Borough       1303                               Harvey Cedars Borough                                  1510
Asbury Park City        1304 moRRIS CoUnTY                 Island Heights Borough                                 1511
Atlantic Highlands Bor. 1305 Boonton Town             1401 Jackson Township                                       1512
AvonbytheSea Bor.    1306 Boonton Township         1402 Lacey Township                                         1513
Belmar Borough          1307 Butler Borough           1403 Lakehurst Borough                                      1514
Bradley Beach Borough   1308 Chatham Borough          1404 Lakewood Township                                      1515

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                                      2009 County/Municipality Codes
Enter the appropriate four-digit number in the boxes below the social security number boxes on Form PTR-1. These codes 
are for Division of Taxation purposes only. If the place where you live is not listed, see instructions on page 5.

Municipality                     Code    Municipality          Code       Municipality                                Code

Lavallette Borough       1516         Quinton Township         1712 Vernon Township                               1922
Little Egg Harbor Twp.   1517         Salem City               1713 Walpack Township                              1923
Long Beach Township      1518         Upper Pittsgrove Twp.    1714 Wantage Township                              1924
Manchester Township      1519         Woodstown Borough        1715
Mantoloking Borough      1520                                       UNION COUNTY 
Ocean Gate Borough       1522         SOMERSET COUNTY               Berkeley Heights Twp.                         2001
Ocean Township           1521         Bedminster Township      1801 Clark Township                                2002
Pine Beach Borough       1523         Bernards Township        1802 Cranford Township                             2003
Plumsted Township        1524         Bernardsville Borough    1803 Elizabeth City                                2004
Point Pleasant Borough   1525         Bound Brook Borough      1804 Fanwood Borough                               2005
Pt. Pleasant Beach Bor.  1526         Branchburg Township      1805 Garwood Borough                               2006
Seaside Heights Borough  1527         Bridgewater Township     1806 Hillside Township                             2007
Seaside Park Borough     1528         Far Hills Borough        1807 Kenilworth Borough                            2008
Ship Bottom Borough      1529         Franklin Township        1808 Linden City                                   2009
South Toms River Bor.    1530         Green Brook Township     1809 Mountainside Borough                          2010
Stafford Township        1531         Hillsborough Township    1810 New Providence Borough                        2011
Surf City Borough        1532         Manville Borough         1811 Plainield City                                2012
Toms River Township      1508         Millstone Borough        1812 Rahway City                                   2013
Tuckerton Borough        1533         Montgomery Township      1813 Roselle Borough                               2014
                                      North Plainield Borough  1814 Roselle Park Borough                          2015
PASSAIC COUNTY                        Peapack & Gladstone Bor. 1815 Scotch Plains Township                        2016
Bloomingdale Borough     1601         Raritan Borough          1816 Springield Township                           2017
Clifton City             1602         Rocky Hill Borough       1817 Summit City                                   2018
Haledon Borough          1603         Somerville Borough       1818 Union Township                                2019
Hawthorne Borough        1604         South Bound Brook Bor.   1819 Westield Town                                 2020
Little Falls Township    1605         Warren Township          1820 Winield Township                              2021
North Haledon Borough    1606         Watchung Borough         1821
Passaic City             1607                                       WARREN COUNTY 
Paterson City            1608         SUSSEX COUNTY                 Allamuchy Township                            2101
Pompton Lakes Borough    1609         Andover Borough          1901 Alpha Borough                                 2102
Prospect Park Borough    1610         Andover Township         1902 Belvidere Town                                2103
Ringwood Borough         1611         Branchville Borough      1903 Blairstown Township                           2104
Totowa Borough           1612         Byram Township           1904 Franklin Township                             2105
Wanaque Borough          1613         Frankford Township       1905 Frelinghuysen Township                        2106
Wayne Township           1614         Franklin Borough         1906 Greenwich Township                            2107
West Milford Township    1615         Fredon Township          1907 Hackettstown Town                             2108
Woodland Park Borough    1616         Green Township           1908 Hardwick Township                             2109
                                      Hamburg Borough          1909 Harmony Township                              2110
SALEM COUNTY                          Hampton Township         1910 Hope Township                                 2111
Alloway Township         1701         Hardyston Township       1911 Independence Township                         2112
Carneys Point Township   1702         Hopatcong Borough        1912 Knowlton Township                             2113
Elmer Borough            1703         Lafayette Township       1913 Liberty Township                              2114
Elsinboro Township       1704         Montague Township        1914 Lopatcong Township                            2115
Lower Alloways Crk. Twp. 1705         Newton Town              1915 Mansield Township                             2116
Mannington Township      1706         Ogdensburg Borough       1916 Oxford Township                               2117
Oldmans Township         1707         Sandyston Township       1917 Phillipsburg Town                             2119
Penns Grove Borough      1708         Sparta Township          1918 Pohatcong Township                            2120
Pennsville Township      1709         Stanhope Borough         1919 Washington Borough                            2121
Pilesgrove Township      1710         Stillwater Township      1920 Washington Township                           2122
Pittsgrove Township      1711         Sussex Borough           1921 White Township                                2123

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