INSTRUCTIONS: ARIZONA SENIOR PROPERTY VALUATION PROTECTION OPTION (Form 82104)

Arizona residents who are at least 65 years of old who have lived at their primary residence for at least 65 years and whose total income does not exceed the amount specified by law may use a form 82104 to have the valuation of their residence frozen. This document can be obtained from the website of the Arizona Department of Revenue.

Arizona Senior Property Valuation Protection Option 82104 Step 1: Indicate with a check mark whether this is an initial application or a notice of reapplication.

Arizona Senior Property Valuation Protection Option 82104 Step 2: Enter the application date on the first blank line and the county name on the second blank line.

Arizona Senior Property Valuation Protection Option 82104 Step 3: On the next three blank lines, enter the book, map and parcel numbers of the parcel.

Arizona Senior Property Valuation Protection Option 82104 Step 4: On the next blank line, enter the name of the applicant.

Arizona Senior Property Valuation Protection Option 82104 Step 5: On the next three blank lines, enter the primary residence street address, city and zip code.

Arizona Senior Property Valuation Protection Option 82104 Step 6: On the next blank line, enter the number of years lived at this primary residence.

Arizona Senior Property Valuation Protection Option 82104 Step 7: Indicate with a check mark whether you are the primary owner. If co-owned, enter the total number of owners.

Arizona Senior Property Valuation Protection Option 82104 Step 8: On the next blank line, enter the date of birth of the qualified owner who is 65 or older.

Arizona Senior Property Valuation Protection Option 82104 Step 9: In the table provided, you must document your income from all sources as listed from the previous three calendar years.

Arizona Senior Property Valuation Protection Option 82104 Step 10: Where indicated, enter your total annual combined income for the last three years and your three year average income.

Arizona Senior Property Valuation Protection Option 82104 Step 11: On the next two blank lines, print your name and enter your phone number.

Arizona Senior Property Valuation Protection Option 82104 Step 12: On the next blank line, enter your signature.

Arizona Senior Property Valuation Protection Option 82104 Step 13: On the next blank line, enter the date.