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Renter's Rebate Checklist

Proof of Income for the year 2016

             *Wages (W-2)                      *Social Security-Form SSA-1099
*Dividends, Interest & Annunities        *Lottery Winnings
*Pension-Form 1099                             *Veterans Pension
*Railroad Retirement                             *Severence Pay
*Unemployment                                  *Workers Compensation
*Alimony                                                   *IRA Distributions
*If you filed a tax return for the year 2016, please bring that along

Proof of Expenses for year 2016

               Proof of rent paid in year 2016
                Proof of gas,oil, kerosene, propane and electricity paid in year 2016
                Proof of water paid in year 2016

Proof the expenses can be in the form of cancelled checks,or rent receipts,money order receipts,or a payment history from utility companies,rental office or landlord