Rock Island County, IL · Rock Island County
Physician’s Statement for the Homestead Exemption for Persons with Disabilities
This form documents disability information for a Homestead Exemption for Persons with Disabilities request when an applicant cannot provide another accepted proof of disability.
At a glance
- Issued by
- City of Rock Island County · Rock Island County, Rock Island County, Illinois
- Notarization
- Not required: file this form without a notary.
- Official source
- rockislandcountyil.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Applicants who cannot provide another accepted proof of disability use this form to support a Homestead Exemption for Persons with Disabilities request. The applicant enters property and assessment-year details, and a physician or other listed medical professional provides patient and disability information, then signs and dates the statement. The form also lists other accepted proof and allows a legal description if the property index number is unavailable.
Who needs it
Property owners requesting the exemption who cannot provide another listed proof of disability must complete the applicant section and have a listed medical professional complete the statement.
How to submit it
File or mail the completed form to the Chief County Assessment Officer at the address shown on the form, before the county’s due date for the exemption.
About notarization
This document is signed without a notary; the applicant and medical professional sign and date it, and no attached or related step is stated to require notarization.
How to submit this form
- 1
Download the Form
Download the Physician’s Statement for the Homestead Exemption for Persons with Disabilities.
- 2
Complete Applicant Information
Enter the property owner’s details, assessment year, and property index number; attach a legal description if the PIN is unavailable.
- 3
Have a Medical Professional Complete It
A physician or other listed medical professional completes the patient and disability sections and signs and dates the statement.
- 4
Submit to the County
File or mail the completed form to the Chief County Assessment Officer at the address shown on the form before the county’s due date.
Frequently asked questions
- Do I need a notary for the Physician’s Statement?
- No. The form calls for signatures and dates from the applicant and medical professional, not a notary. It does not say that any attachment or related step must be notarized.
- How do I submit the completed form?
- File or mail it to the Chief County Assessment Officer at the address shown on the form, before the county’s due date for the Homestead Exemption for Persons with Disabilities.
- When should I use this form?
- Use it when requesting the Homestead Exemption for Persons with Disabilities if you cannot provide any of the other acceptable proofs of disability listed on the form.
- What information does the form ask for?
- The applicant provides property, assessment-year, and contact details. A listed medical professional supplies patient and disability information, license details, and a signed statement.