Try for free

North Carolina AV-9A Certification of Disability

North Carolina homeowners applying for the Elderly or Disabled Homestead Exclusion or Circuit Breaker deferral under G.S. 105-277.1 on the basis of disability need AV-9A. A North Carolina physician, or an agency authorized to determine disability benefits, certifies the applicant is totally and permanently disabled and was under their care on January 1.

Who completes it

The applicant fills in name, address, phone numbers, Social Security number and date of birth. A physician licensed in North Carolina, or a governmental agency authorized to determine disability benefits, answers the two certifications and signs with title, license number and practice or agency name.

Submitting and payment

How to submit it
The completed certification goes to the county tax assessor with Form AV-9, not to the North Carolina Department of Revenue.
Who pays
The Department of Revenue sets no fee and the form does not say who pays the physician.

Good to know

  • Totally and permanently disabled means an impairment that substantially precludes gainful employment and appears reasonably certain to continue without substantial improvement for life (G.S. 105-277.1(b)(4)).
  • Evidence that someone receives disability payments is not, by itself, evidence of total and permanent disability.
  • AV-9A is not used for the disabled veteran exclusion under G.S. 105-277.1C, which requires certification from the appropriate federal agency.
  • Social Security number disclosure is mandatory, and the county may use it to verify information and to collect unpaid property taxes.

Get the official form

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

Certification of Disability for Property Tax Exclusion (G.S. 105-277.1)

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Who can sign North Carolina form AV-9A?

A physician licensed to practice medicine in North Carolina, or a governmental agency authorized to determine qualification for disability benefits. The signer affirms they are qualified and authorized to make the determination, and gives title, license number and the name of the medical practice or agency.

What does the physician certify on AV-9A?

Two yes or no statements: that the applicant is currently totally and permanently disabled as defined in G.S. 105-277.1(b)(4), and that the applicant was under the physician's care as of January 1 of this year and was totally and permanently disabled on that date.

Does receiving disability benefits qualify someone for the AV-9A?

Not by itself. The form states that evidence someone receives disability payments is not evidence of total and permanent disability. The physician or authorized agency must certify that the statutory definition in G.S. 105-277.1(b)(4) is met.