CITY OF BOULDER - 2024 FOOD TAX REBATE APPLICATION - INSTRUCTIONS FOR COMPLETING THIS APPLICATION

Sep 19, 2026

City of Boulder Food Tax Rebate Application instructions explain eligibility for households seeking a rebate for 2023 food-related taxes. Applicants must meet financial income limits, maintain Boulder residency throughout the 2023 calendar year, and qualify as either an older adult (age 62+), a person with a disability, or a family with children under 18. The document details the March 1 to June 30, 2024 application period, submission by mail or in person, staff assistance contact information, required documentation, and signature requirements under penalty of perjury.

LanguageEnglish

CategoryForms

FormatPDF

Pages9

Reading Time3 min

AccessFree to download

Who Qualifies?

Financial Eligibility Guidelines

Application Period

Application Submission

Questions and Assistance

Application Form Sections

Housing and Human Services Department

Family Members

Oath of Applicant

Document Checklist

CITY OF BOULDER 2024 FOOD TAX REBATE APPLICATION INSTRUCTIONS FOR COMPLETING THIS APPLICATION Who Qualifies? Applicants must: • Meet financial eligibility guidelines (see chart below); • and have been a resident of Boulder for the entire 2023 calendar year; • and qualify as one of these three categories: o age 62 or over for the entire 2023 calendar year; o or a person with a disability; o or a family with children under 18 years ofage in the household for the entire 2023 calendar year Financial Eligibility Guidelines Households must meet the income limits below. Use “Total Income (line 9)” from your 2023 Federal 1040 or 1040SR tax form. If not required to file an income tax return, use total income from all sources. | Family Size | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Income Limit | 46,500 | 53,150 | 59,800 | 66,400 | 71,750 | 77,050 | 82,350 | 87,650 | Application Period March 1, 2024-June 30, 2024. Rebates will be mailed to households as applications are approved, which may take up to 2 months. No late applications or documentation will be accepted. Application Submission | Submit in Mail:
Postmark by June 30, 2024 | Food Tax Rebate Program
1101 Arapahoe Ave
Boulder, CO 80302 | | --- | --- | | Submit in Person:
Office hours, Fridays 1-4pm; April 1-June 28 No appointment necessary; first come first serve | New Britain Building:
1101 Arapahoe Ave.
Boulder, CO 80302 | Questions and Assistance For more information or assistance call 303-441-4261 and leave a message. We will return your call as soon as possible. This Page intentionally left blank CITY OF BOULDER FOOD TAX REBATE APPLICATION (For rebate of taxes from 2023) CITY OF BOULDER HOUSING AND HUMAN SERVICES DEPARTMENT | Please check one: | | | | | Staff Use | | | --- | --- | --- | --- | --- | --- | --- | | 􀀀 Family with children under the age of eighteen (18) for all of 2023: rebate-$318 Please fill out the ‘Family Members’ section on next page.
􀀀 Individual with a disability: rebate- $104
􀀀 Older Adult-must have turned 62 on or before January 1, 2023: rebate- $104 | | | | | [ ]
[ ][ ]
[ ] BHP | | | Last Name | | First Name | | Middle Initial | | | | Street Address (Do not use P.O. Box) | | | | Apt. or Unit \# | | | | City | State | | Zip Code | | | | | Mailing Address (if different than Street address) | | | | Apt or Unit \# | | | | City | State | | Zip Code | | | | | Date ofBirth | | | Today’s Date | | | | | Phone Number: Mobile [] Home [] | | | Email Address | | | | | Race
􀀀 African (Black) or African American
􀀀 American Indian or Alaskan Native
􀀀 Asian
􀀀 Hawaiian Native or Pacific Islander
􀀀 Hispanic or Latino/Latina
􀀀 Other
􀀀 Two or more races
􀀀 White or Caucasian | | | Gender:
􀀀 Female
􀀀 Male
􀀀 Transgender
􀀀 Prefer to self identify | | | | Application continues on other side. | FAMILY MEMBERS
Please only fill out the section below if you are applying as a family with at least one child
under the age of 18 for all of 2023. | | | | | --- | --- | --- | --- | | Name | Date ofBirth | Name | Date ofBirth | | | | | | | | | | | | OATH OF APPLICANT
I declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and complete to the best of my knowledge. I hereby grant my permission to City of Boulder staff to verify my federal income tax return and to have information released to them. | | | --- | --- | | Signature | Date | THE CITY OF BOULDER WILL NOT PROCESS UNSIGNED APPLICATIONS DOCUMENT CHECKLIST: First Time Applicants PLEASE INDICATE THE DOCUMENTATION YOU ARE ATTACHING 1. Photo ID: U. S. or foreign government-issued photo ID including full name, date ofbirth, and photo. This ID must be valid or expired within the last 2 years. 􀀀 Form of ID you are attaching (driver’s lice

FAQs

Who qualifies for the City of Boulder 2024 Food Tax Rebate?

Applicants must meet financial eligibility income limits, be Boulder residents for the entire 2023 calendar year, and fall into one of three categories: age 62 or over, disability, or a family with children under 18 for all of 2023.

What is the application deadline and how are rebates delivered?

Applications must be submitted between March 1, 2024 and June 30, 2024. Rebates are mailed as applications are approved, and processing may take up to two months; late applications and documentation are not accepted.

What documents are required to submit with a first-time application?

First-time applicants must include photo ID, proof of residency, proof of income (such as a 2023 federal income tax return or an appropriate oath form), and documentation supporting the chosen category (family children, disability, or age). The application must also be signed, and unsigned applications will not be processed.

Sep 19, 2026

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