06/19/2026
If you want a copy of this, I can email to you. I will also have copies for you when I have my sitting hours in August for you to pick up.
EXHIBIT A
BOYERTOWN AREA SCHOOL DISTRICT PROPERTY TAX/RENT REBATE CLAIM FORM
Tax Year - 2025-2026
PLEASE PRINT LEGIBLY OR TYPE
FILING INSTRUCTIONS
WHERE TO FILE: 911 Montgomery Avenue, Boyertown, PA 19512
WHEN TO FILE: After July 1, 2026, but before January 4, 2027
Name of Claimant:
PART A - Personal Information
Address of Property Owned or Rented by Claimant:
Birth Date of Claimant:
Social Security Number of Claimant:
PART B - Form PA-1000 2025 (Property Tax or Rent Rebate Claim)
Insert amount from Line 13 on Form PA-1000 2025 (Total Income)
$
PART C - Calculation of Property Tax/Rent Rebate from School District Insert the Property Tax/Rent Rebate amount claimed by using the below chart:
$
EA
If Dollar Amount Listed in Part B: $0-$8,550
Then Property Tax/Rent Rebate Claimed:
$250.00
$8,551-$16,040
$200.00
$16,041-$19,240
$150.00
$19,241-$48,110
$100.00
PART D-Required Information
(a) Copy of Form PA-1000 2025 (Property Tax or Rent Rebate Claim) filed with the PA Dept. of Revenue, with all required and appended forms/documentation.
(b) Evidence of receipt of rebate from the PA Dept. of Revenue.
I declare that this form is true, correct and complete, that the documents required and attached hereto are true and correct copies of those documents, and that to the best of my knowledge and belief this is the only claim filed by members of my household.
Claimant's Signature
Date
Signature of Preparer (if other than Claimant)
Telephone Number
5
Property Tax/Rent Rebate Resolution