Form PC-501SC, Household Income Sworn Statement and Return, is the Pinellas County Property Appraiser's form for the Senior Citizen Exemption for Persons Age 65 and Over, on which the applicant swears to the household's adjusted gross income. It is one of the Pinellas County property tax forms, and the exemption it supports applies only to the property taxes of the taxing authority that grants it. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the original is published by the Pinellas County Property Appraiser at pcpao.gov.
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What is PC-501SC?
Form PC-501SC, Household Income Sworn Statement and Return, is the Pinellas County Property Appraiser form on which a homeowner age 65 or older reports household income and certifies eligibility for the Senior Citizen Exemption under Florida law.
The form is the application for the additional homestead exemption for persons age 65 or older described in Section 196.075, Florida Statutes. The exemption applies only to the property taxes of the taxing authority that grants it. The copy you are shown is revision Rev 12/21 and is printed for Application Year 2026.
Page 1 has four blocks. Part 1 lists every person living in the homestead on January 1 of the year of the exemption, with date of birth, whether each filed an IRS return and each person's adjusted gross income, and totals the household figure. Part 2 lists what to submit for members who file an IRS Form 1040 series return. Part 3 lists what to submit for members who do not. A sworn certification and signature block closes the page.
Page 2 holds the instructions and a Statement of Income for household members who did not file a Form 1040 or 1040A. The form defines "household" as a person or group living together as a housing unit, excluding people boarding in or renting part of the dwelling. "Household income" is the adjusted gross income in Section 62 of the U.S. Internal Revenue Code, the amount reported on IRS Form 1040, for all household members.
Who needs to file PC-501SC?
Homeowners who are at least 65 years old on January 1 of the tax year they are applying for, who own and occupy the property as permanent residents of Florida, and whose household income is within the limit printed on the form, use Form PC-501SC to apply for the Senior Citizen Exemption.
Conditions the form attaches to the application:
- The total prior-year adjusted gross income of everyone living in the household on January 1 of the tax year must not exceed the maximum printed on the form for the application year.
- Part 1 lists all persons living in the homestead on that date. Renters and boarders are not included.
- Household members who filed a Form 1040 series return follow Part 2. Members who did not follow Part 3 and complete the Statement of Income on page 2.
- The Statement of Income is for members whose income is below the IRS filing thresholds and who have not filed Form 1040 or 1040A. Do not complete it for minor children with no income.
The applicant signs the certification under penalty of perjury. The form does not describe anyone else signing for the applicant.
When to file PC-501SC
The statement must be filed with the property appraiser by March 1. For prompt consideration, submit the supporting documents by May 1. The form states that no further documentation will be accepted after June 1.
Eligibility is measured on January 1: you must be at least 65 years old on January 1 of the tax year you are applying for, and the household is the people living in the homestead on that date. The income reported is the prior year's adjusted gross income. If you filed an Application for Automatic Extension of Time to File U.S. Individual Income Tax instead of a return, the form accepts that document in Part 2. The form prints no processing time.
Documents you need
- For each household member who files an IRS Form 1040 series return: IRS Form 1040 (first 2 pages) or an Application for Automatic Extension of Time to File U.S. Individual Income Tax.
- For each member who does not file a Form 1040 series return: a copy of the prior year's Social Security Statement (SSA 1099), if applicable.
- For each member who does not file a Form 1040 series return: all relevant 1099s for income received in the prior year.
- For each member who does not file a Form 1040 series return: a Statement of Income, completed on page 2 of the form.
- Other supporting documents the form gives as examples: Form 1040A, Form 1040EZ, W-2 forms, RRB 1099, RRB 1042S, SSA 1042S, Form 1099A, rental receipts and partnership income (1065).
How to fill out PC-501SC
Enter parcel and owner details
At the top of page 1, enter the Parcel ID Number, the names of Owner 1 and Owner 2 if there is a second owner, and the mailing address and physical address. The Application Year is printed as 2026.
List every household member in Part 1
Write the name and date of birth of each person living in the homestead on January 1 of the year of exemption. Do not include renters or boarders.
Mark IRS return status and income
For each member, check Yes or No under Filed IRS return? and enter that person's adjusted gross income. Enter the combined figure on the line Total adjusted gross income for all household members.
Gather documents for filers (Part 2)
For each member marked Yes, prepare IRS Form 1040 (first 2 pages) or an Application for Automatic Extension of Time to File U.S. Individual Income Tax.
Gather documents for non-filers (Part 3)
For each member marked No, prepare the prior year's Social Security Statement (SSA 1099) if applicable, all relevant 1099s and a completed Statement of Income.
Complete the Statement of Income
On page 2, enter the applicant name and record each income type as annual income (monthly amounts x 12): interest, pension, dividends, annuities, earned income, investment income, taxable retirement, rents, taxable VA benefits, capital gains, royalties and trust fund income. Enter the Total Adjusted Gross Income.
Report non-taxable income
On page 2, also fill in Social Security Benefits, Railroad Benefits, Non Taxable Vet Pension, Tax Exempt Interest and Other non taxable income, with the source and amount for any other income. Leave out SSI payments and child support.
Read the certification and sign
Confirm you are at least 65 on January 1 of the tax year, the household income is within the printed limit, and you own and occupy the property as a Florida permanent resident. Sign, date, print your name and enter phone and email.
Review and download the completed PDF
Check that every household member is listed, totals match and the signature is in place. Download or print the completed PDF from FillingPDF and assemble the package described under How to submit.
How to submit PC-501SC
The form says only that it must be filed with the property appraiser, so it goes to the Pinellas County Property Appraiser. It prints no mailing address, portal or appointment rule; the agency publishes the form at https://www.pcpao.gov/sites/default/files/SeniorExemption_Application.pdf, so confirm how and where to deliver it with that office.
What to send:
- The signed form. Page 1 must carry the applicant's signature, date and phone, with Part 1 completed and the total adjusted gross income entered.
- Supporting documents. Include the items listed in Part 2 for each member who files a Form 1040 series return, and in Part 3 for each member who does not. Page 2 is part of the package whenever any member completes a Statement of Income.
- Timing. The statement is due by March 1, supporting documents are best received by May 1, and nothing more is accepted after June 1.
The form names no fee. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels.
Common mistakes to avoid
- Listing renters or boarders in Part 1; the form says to list all persons living in the homestead on January 1 and not to include renters/boarders.
- Filing after March 1, or sending supporting documents after June 1, when the form says no further documentation will be accepted.
- Submitting a full-year income figure from monthly amounts without multiplying; the Statement of Income must show annual income (monthly amounts x 12).
- Skipping the Social Security, railroad, non-taxable veteran pension, tax-exempt interest and other non-taxable income lines; the form says to provide them even though they are not part of adjusted gross income.
- Including Supplemental Security Income (SSI) as Social Security benefits; the form says SSI payments are not included.
- Adding child support to the other-income line; the form says not to include income that would not be in adjusted gross income, such as child support.
- Completing the Statement of Income for a minor child with no income or for a member who filed a Form 1040 or 1040A.
- Attaching a full tax return when the form asks for the first 2 pages of IRS Form 1040 in Part 2.
- Leaving the certification unsigned or giving false information; the form warns that knowingly and willfully false information to claim homestead exemption is a first-degree misdemeanor.
Frequently asked questions
What is Form PC-501SC used for?
Form PC-501SC, Household Income Sworn Statement and Return, is the Pinellas County Property Appraiser's application for the Senior Citizen Exemption for Persons Age 65 and Over. The applicant swears to the household's prior-year adjusted gross income and certifies eligibility under Florida law.
Who qualifies for the Pinellas County senior citizen exemption?
You must be at least 65 on January 1 of the tax year, own and occupy the property as a permanent Florida resident, and have household adjusted gross income within the maximum printed on the form for that year. The household is everyone living in the home, excluding renters and boarders.
What is the deadline for Form PC-501SC?
File the statement with the property appraiser by March 1. Submit supporting documents by May 1 for prompt consideration. The form says no further documentation will be accepted after June 1.
What documents do I attach to the senior exemption application?
Members who file a Form 1040 series return attach the first 2 pages of Form 1040 or an extension application. Members who do not file attach the prior year's SSA 1099 if applicable, all relevant 1099s and a completed Statement of Income from page 2.
Who counts as a household member on Form PC-501SC?
A household is a person or group living together as a housing unit in a room or group of rooms. List everyone living in the homestead on January 1, but not renters or boarders. Minor children with no income do not complete the Statement of Income.
Where do I send the Pinellas County senior exemption form?
The form says it must be filed with the property appraiser, meaning the Pinellas County Property Appraiser. It prints no address or portal, so confirm the delivery method with that office, which publishes the form at pcpao.gov.
What is the Statement of Income on page 2 for?
It reports annual income for household members whose income is below the IRS filing thresholds and who did not file Form 1040 or 1040A. Enter amounts as annual income (monthly amounts x 12), plus the non-taxable benefits the form requires you to list.
Can I fill out Form PC-501SC online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the form with the Pinellas County Property Appraiser; you submit it through the agency's channels.
What happens if I give false information on the form?
The form warns that anyone who knowingly and willfully gives false information to claim homestead exemption is guilty of a first-degree misdemeanor under s. 196.131(2), F.S., punishable by imprisonment of up to 1 year, a fine or both.
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