DUCHESNE COUNTY 2026 TAX RELIEF APPLICATION

ONLY PRIMARY RESIDENCE AND UP TO 1 ACRE

WILL BE ELIGIBLE FOR EXEMPTIONS

For County Use Only
Tax Amount
Blind &/Or Veteran
Circuit Breaker
Additional 20%
Low Income Abatement
Net Tax Due

Please CIRCLE the type(s) of relief you are applying for:

Veteran

Active Military

Circuit Breaker/Abatement

Blind

Mobile Home

Applicant Last Name

First Name

Middle Name

Date of Birth

Social Security Number

Spouse’s Last Name

First Name

Middle Name

Date of Birth

Social Security Number

Mailing Address

City

State

Zip Code

Phone Number

Parcel/Account Number

Mobile Home (List Year, Make & Serial #)

YES NO

Did you own this property as of January 1, 2026?

YES NO

Have you been living in your home since January 1, 2026?

YES NO

Is your property in a Trust Agreement? If yes, you must provide a copy for our office if we don’t have on

YES NO

Have you filed for any tax relief this year in another county?

YES NO

Do you plan on filing for any tax relief in another county?

CIRCUIT BREAKER AND ABATEMENT EXEMPTION

YES NO

Will you be age 66 or older before December 31, 2026?

YES NO

If under age 66, are you an unmarried widow or widower? If you answered yes, please enter the month and year of spouse’s death: A copy of the death certificate must be on file in our office.

YES NO

Will you reside at this address for 12 months out of the year? If no, please explain.

YES NO

Will you live in Utah for the entire Year of 2026?

YES NO

Were you financially self-supportive in 2025?

YES NO

Does your property exceed one acre? If yes, how many acres?

YES NO

Do you rent out a portion of your home?

YES NO

Do you use a part of your home for business?

2025 GROSS INCOME – For Circuit Breaker and Abatement Applications Only

INCLUDE INCOME FROM ALL HOUSEHOLD MEMBERS

MUST ATTACH COPY OF VERIFIED INCOME DOCUMENTATION

Wages, Salaries, Tips, Other Compensation, Oil Royalties

Total Interest, Dividends (Taxable & Non-Taxable)

Pensions, Annuities, (Includes IRA’s)(Taxable & Non-Taxable)

Social Security, Railroad Retirement (Taxable & Non-Taxable)

Capital Gains, Loss Carry Forwards.

Government Assistance

Unemployment, Workers Comp

Business, Rental, Farm Income. Must Show Copy On Income Tax Return

Other Income (Alimony, Child Support ETC. Provide Supporting Documentation)

TOTAL 2025 GROSS HOUSEHOLD INCOME

List All Other Persons Living in Household

Name

Age

Relationship

Name

Age

Relationship