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North Dakota Form 24746: Physician's Certificate

A licensed physician signs this one-page certificate when a North Dakota applicant younger than 65 claims the homestead property tax credit or renter's refund as a permanently and totally disabled person under NDCC 57-02-08.1. The applicant then files it as proof of disability with the credit application at the local assessor or county director of tax equalization.

Who completes it

A licensed physician completes the whole certificate: the applicant's name, mailing address, city and county, the date from which the applicant is permanently and totally disabled, and the physician's printed name, address, signature and date. The applicant fills out the separate credit or refund application.

Submitting and payment

How to submit it
Give the signed certificate to the applicant, who attaches it to the Homestead Credit Application for Senior Citizens & Disabled Persons, or to the renter's refund application, filed with the local assessor or county director of tax equalization; homestead credit applications are due April 1.
Who pays
The certificate lists no fee, billing code or state payment for the physician.

Good to know

  • The certificate quotes the statutory definition: inability to engage in any substantial gainful activity because of a medically determinable impairment expected to result in death or lasting at least 12 continuous months.
  • It is required only for applicants under 65 who claim as permanently and totally disabled; applicants 65 or older qualify for the credit by age.
  • A written disability determination from the Social Security Administration, or from another federal or state agency authorized to certify disability, is accepted instead of the physician's certificate.
  • The current version is 24746 (Rev. 3/2016). The credit also has an income limit that counts the income of the applicant's spouse and dependents.

Get the official form

Download the current version from the source each time; forms change without notice.

Physician's Certificate

Official pagePDF

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Frequently asked questions

Who can sign North Dakota Form 24746?

Only a licensed physician. The definition printed on the form, from North Dakota Century Code 57-02-08.1(5)(e), says permanent and total disability is established by a certificate from a licensed physician. An applicant with a disability determination from Social Security or another authorized agency can submit that written determination as proof instead.

What date goes on the North Dakota physician's certificate?

The physician enters the date as of which the applicant is permanently and totally disabled. The statute quoted on the form ties eligibility to being disabled in the year the tax was levied, so the date should cover that year. The physician also prints their name and address, signs, and dates the certificate.

When is the North Dakota homestead credit application due?

The application, with proof of disability for applicants under 65, goes to the local assessor or county director of tax equalization by April 1 of the year the property is assessed and the credit is requested. Renters claiming as disabled use the same certificate with the renter's refund application.