PTAX-343-A Physician’s Statement for the Homestead Exemption for Persons with Disabilities

PTAX-343-A (R-12/13) IL-492-4547

To qualify for the Homestead Exemption for Persons with Disabilities (HEPD), proof of a disability is required. The acceptable proof of disability is listed on the back of this Form. If you are unable to provide any of these as proof of your disability, you and an Illinois licensed physician must complete Form PTAX-343-A. You are responsible for any physicians’ costs.

By signing this form, the applicant hereby waives all claims to the exemption(s) specified for the tax year indicated, for the property described by the Property Index Number indicated. This form may be submitted entirely online. After you submit this form it will be received by Cook County Assessor's Office staff for review.