A: Were you a resident of Oklahoma for the entire year?.................................... Yes No B: Are you or your spouse 65 or over? If no, answer question “C”...................... Yes No C: Were you totally disabled for the full year? If yes, please submit proof........ Yes No D: Are you required to file an Oklahoma Income Tax return this year?................ Yes No This form is due on or before June 30, 2024. ( ) FORM 538-H Note: If “yes” on line D, this claim MUST be provided with a credit claimed on Form 511. (if you marked “no” on line A, do not file this form) (if you marked “no” on both lines B and C, do not file this form) 2 0 2 3 Yearly Income YOU MAY NOT ENTER NEGATIVE AMOUNTS YOU MAY NOT ENTER NEGATIVE AMOUNTS (Round to Nearest Dollar) 1. Enter total wages, salaries, fees, commissions, bonuses, and tips

(including nontaxable income from your W-2)....................................................................................... 1 2. Enter total interest and dividend income received................................................................................. 2 3. Total of all dependents’ income.............................................................................................................. 3 4. Social Security payments (total including Medicare)............................................................................. 4 5. Railroad Retirement benefits................................................................................................................. 5 6. Other pensions, annuities and IRAs...................................................................................................... 6 7. Alimony.................................................................................................................................................. 7 8. Unemployment benefits......................................................................................................................... 8 9. Earned Income Credit (EIC) received in 2023....................................................................................... 9 10. Nontaxable sources of income (specify) _ _______________________________________............... 10

Examples of nontaxable sources of income are: Veterans disability payments, workers’ compensation,

loss of time insurance, support money and public assistance (housing assistance, cash, etc.) 11. Enter gross (positive) income from rentals, royalties, partnerships, estates & trusts, and gains

from the sale or exchange of property (taxable and nontaxable) (provide Federal return including

schedules).............................................................................................................................................. 11 12. Enter gross (positive) business and farm income (provide Federal return including schedules)........... 12 13. Other (specify) ____________________________________________............................................... 13 14. Total gross household income (Add lines 1-13)

If over $12,000, STOP, you don’t qualify for the credit or refund.................................................... 14 Enter TOTAL GROSS income and assistance, taxable and nontaxable, received by ALL members of your household in 2023. Present Home Address (Number and street, including apartment number or rural route) City State ZIP Taxpayer’s First Name Taxpayer’s Social Security Number Spouse’s Social Security Number Phone Number Spouse’s First Name (If a Joint Return) Middle Initial Middle Initial Last Name Last Name PART 1: QUALIFICATION QUESTIONS PART 2: GROSS HOUSEHOLD INCOME 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Claim for Credit or Refund of Property Tax State of Oklahoma

Claimant’s Signature and Date Spouse’s Signature and Date Under penalty of perjury, I declare the information contained in this document and any attachments is true and correct to the best of my knowledge and belief. 15. Enter the amount of 2023 real estate taxes paid on your homestead................................................... 15

A copy of your tax bill must be provided with this claim form. 16. To compute credit or refund allowable: Multiply the amount of total household income from

Part 2, line 14: $_______________________X 1% (0.01). Enter result here................................... 16 17. Amount of credit or refund, subtract line 16 from line 15 (not to exceed $200)..................................... 17 18. If you are required to file an Oklahoma Income Tax return, enter the amount

from line 17 here and as a credit on Form 511, line 24.......................................................................... 18 19. If you are NOT required to file an Oklahoma Income Tax return, enter the amount from line 17 here.

(This amount will be refunded either by direct deposit or debit card; see instructions)......................... 19 2023 Form 538-H - Claim for Credit or Refund of Property Tax - Page 2 Name(s) Shown on Form 538-H: Your Social Security Number: PART 3: GROSS HOUSEHOLD INCOME OF $12,000 OR LESS DIRECT DEPOSIT OPTION: For those NOT filing a Form 511 (See page 3 to see if you qualify for Direct Deposit). 00 00 00 00 00 Is this refund going to or through an account that is located outside of the United States? Yes No Routing Number: Checking Account Savings Account Account Number: Deposit my refund in my: Refund Note: For Direct Deposit, verify your account and routing numbers are correct. If your direct deposit fails to process, you will receive a debit card. If no options are selected, you will receive a debit card. Due to electronic banking rules, the OTC will not allow direct deposits to or through foreign financial institutions. If you use a foreign financial institution you will be issued a paper check.

Instructions for Form 538-H Part 2 Part 3 2023 Form 538-H - Page 3 For this form “Gross Household Income” means the amount of income of every type, regardless of the source (except for gifts) received by ALL persons living in the same household, whether the income was taxable or not for income tax purposes. This includes, but is not limited to, pensions, annuities, social security, unemployment payments, veterans dis­ ability compensation, school grants or scholarships, public assistance payments, alimony, support money, workers’ com­ pensation, loss-of-time insurance payments, capital gains, and self-employment. If self-employed, enter the gross income from business, and provide a copy of your Federal return, including all schedules and any other type of income received. (Lines 1 through 13.) Any person 65 years of age or older or any totally disabled person who is the head of household, a resident of and domi­ ciled in this state during the entire preceding calendar year and whose gross household income for such year does not exceed $12,000 may file a claim for property tax relief on the amount of property taxes paid on the household occupied by such person during the preceding calendar year. Each head of household shall be allowed to file only one claim per year. The amount of any claim filed shall be for the amount of the property taxes paid by the claimant for the preceding calendar year that exceeds 1% of the total household income, but no claim for property tax relief shall exceed $200. All claims for relief with respect to property taxes shall be received by the Oklahoma Tax Commission (OTC) on or before June 30th each year for property taxes paid for the preceding calendar year. If the due date falls on a weekend or legal holiday when the OTC offices are closed, your return is due the next business day. Your return must be postmarked by the due date to be considered timely filed. An amended return cannot be filed to claim this credit after the due date; the claim must be filed on or before the due date. Claims for property tax relief shall be allowed as a direct tax credit on the taxpayer’s individual income tax return filed for the calendar year involved. In all cases where claimants have no income tax liability, such claim, or any balance thereof, shall be paid out in the same manner and out of the same fund as refunds of income taxes. If you are not filing a Form 511 and would like to have the amount shown on line 19 deposited directly into your checking or savings account, complete the “Direct Deposit Option” section. (If you are filing a Form 511, you will complete the Direct Deposit section on the Form 511.) If you do not choose direct deposit, you will receive a debit card. WARNING! The OTC will not allow direct deposits to or through foreign financial institutions. If you use a foreign financial institution your refund will be mailed to the address shown on your return. Definition of Terms for Form 538-H “Disabled Person” means a person unable to engage in any substantial gainful activity by reason of a medically deter­ mined physical or mental impairment which can be expected to last for a continuous period of 12 months or more. Proof of disability may be established by certification by an agency of State Government, an insurance company or as may be required by the OTC. Eligibility to receive disability benefits under the Federal Social Security Act shall constitute proof of disability. “Household” means any house, dwelling or other type of living quarters, and the real property thereof, occupied by the owner or joint owners as a residence, subject to Ad Valorem taxation. “Head of Household” means a person who as owner or joint owner maintained a home and furnished his own support for said home furnishings and other material necessities. “Property Taxes” means the Ad Valorem taxes on the household actually paid by the head of the household for the pre­ ceding calendar year. Do not include personal property taxes. “Resident of Oklahoma” is defined as a person legally domiciled in this state for the entire tax year. Mailing and Assistance Mail your completed form to: Oklahoma Tax Commission

PO Box 26800

Oklahoma City, OK 73126-0800 If you have questions, call the Taxpayer Resource Center at 405.521.3160. The Oklahoma Tax Commission is not required to give actual notice to taxpayers of changes in any state tax law. Refund Information for those Not Filing a Form 511