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Form Overview

This document is a Request for Waiver of Additional Charges for real estate taxes, issued by the Commonwealth of Pennsylvania. It is designed for taxpayers who have not received their tax notice and wish to pay the face value of the tax without incurring additional interest, fees, or penalties.

Form ID: DCED-CLGS-70 (09/2022)

Eligibility and Requirements

To qualify for this waiver, the applicant must satisfy all five of the following conditions:

• Non-Receipt of Notice: The applicant must confirm they did not receive written notice of real estate taxes from the County, Municipality, or School District.
• Waiver Request: The applicant must explicitly request a waiver of "additional charges" (interest, fees, penalties) that exceed the face amount of the tax.
• Qualifying Event: The request must be filed within twelve months of a qualifying event. This includes:
  • The date of transfer of ownership from the prior owner to the applicant.
  • For mobile/manufactured homes: The date of transfer, the commencement of a lease agreement for the original location, or the relocation to a new parcel.
  • Note: Renewal of a lease for the same location does not count as a qualifying event.
• Documentation: The applicant must attach proof of the qualifying event, such as:
  • A deed showing the transfer date.
  • Title documentation for a mobile/manufactured home.
  • An executed lease agreement showing the commencement date.
• Full Payment: The applicant must attach full payment of the face value amount of the real estate tax (excluding the additional charges).

Submission Instructions

• Recipient: The form must be presented to the Tax Collector.
• Signatures: The request must be signed and dated by the taxpayer.
• Legal Declaration: The form includes a declaration under penalty of perjury (18 Pa. C. S. § 4904) stating that the taxpayer has not received their tax notice and that all information provided is true.

Required Information Fields

The form requires the following details to be filled out:

• Name and Tax Parcel Number
• Address, City, State, and Zip Code
• Phone Number and Email
• Property Location
• Tax Year

For Tax Collector Use Only

The bottom section of the form is reserved for official use, tracking:

• Real Estate Tax due with penalty (broken down by County, Municipal, and School).
• Real Estate Tax paid with the waiver request.
• Penalty/Fees waived.