Form DOR 82514B, Certification Of Disability For Property Tax Exemption – Mohave County, AZ

Form DOR 82514B, Certification Of Disability For Property Tax Exemption, is the Arizona form on which an applicant and an examining medical authority certify that the applicant is totally and permanently disabled, supporting a property tax exemption claim filed with the county assessor.

The form cites Article IX, Section 2 of the Arizona Constitution and A.R.S. Title 42, Chapter 11, Article 3, § 42-11111 and Article 4, §§ 42-11151, 42-11152 and 42-11153. It covers the exemption for a totally and permanently disabled person. The applicant completes the top block (name, address, email, date of birth, marital status, signature and date). The examining medical authority completes the medical certification, answering YES or NO to whether the applicant is unable to engage in any substantial gainful activity, and adds its name, business address, phone number, signature, date and office stamp.

The form defines two terms. A "competent medical authority" is an individual licensed under the Arizona titles listed on the form or comparable law of another state, a registered nurse practitioner as defined in Section 32-1601, or the United States Department of Veterans Affairs, as evidenced by a disability award letter. A "person with a total and permanent disability" is someone unable to engage in any substantial gainful activity, for pay or profit, because of a physical or mental impairment expected to last at least twelve months or to result in death within twelve months.

This form does not replace the DOR 82514 Affidavit of Individual Tax Exemption: it is filed with that affidavit. The form's heading tells veterans to contact their local county assessor for disability filing requirements.

Applicants who are claiming the property tax exemption for a totally and permanently disabled person, and who must file the DOR 82514 Affidavit of Individual Tax Exemption, use this form to document the disability. The applicant signs and dates the top of the form.

The medical certification must be completed by the examining medical authority. The form lists who qualifies: an individual licensed under Title 32, Chapter 8, 13, 14, 17, 19.1, 25 or 29 (chiropractor, physician (allopath, homeopath, osteopath, naturopath), physician assistant, psychologist) or under comparable law of another state; a registered nurse practitioner as defined in Section 32-1601; or the United States Department of Veterans Affairs, as evidenced by a disability award letter.

The condition certified is a total and permanent disability as the form defines it: an inability to engage in any substantial gainful activity, for pay or profit, caused by a physical or mental impairment expected to last a continuous period of at least twelve months or to result in death within twelve months.

Veterans: the form's heading says veterans should contact their local county assessor for disability filing requirements.

File this form with the DOR 82514 affidavit no later than the last business day in February if you want the exemption processed for the current tax year. The form states that a hand-delivered copy must carry both the applicant's and the Medical Authority's signatures and be filed with the DOR 82514 by that date. If the two forms are mailed to the County Assessor, they must be postmarked on or before the last business day of February. The form prints no other deadline, renewal cycle or processing time, so ask the County Assessor about anything beyond the February date.

The form names two channels: hand delivery and mail. In both cases the signed form goes to the County Assessor of the county in which the applicant's property is located, together with the DOR 82514 Affidavit of Individual Tax Exemption.

• Hand delivery: file the copy bearing the applicant's and the Medical Authority's signatures, with the DOR 82514, no later than the last business day in February.
• Mail: send both forms to the County Assessor; they must be postmarked on or before the last business day of February.

For Mohave County, the form lists the Mohave County Assessor at 700 W. Beale Street, Kingman, AZ 86401, phone (928) 753-0703. The same page of the form lists the address and phone number of each of the other Arizona county assessors, for property located elsewhere. Veterans should first contact their local county assessor for disability filing requirements. The form mentions no online filing channel and does not state a fee. FillingPDF lets you fill out and download the PDF; submission follows the channels above.