Homestead Exemption Form

First Name

Last Name

Physical Address

Mailing Address

City

State

Zip Code

Previous Residence Address

Phone Number

Assessment #

Date Acquired (m/d/y)

Previous Owner

I am requesting the Homestead Exemption for the tax year of

By signing below I hereby certify that I am requesting homestead exemption on the above property and that I have read and understand the following:

I am only allowed one homestead exemption, and I must occupy the property in order to qualify. I understand if I no longer reside on the property I must notify the assessor’s office to provide a forwarding address. I also understand that if I rent the property I must notify the assessor’s office and it is no longer eligible for homestead exemption.

Signature

Sign Here

Today's Date (m/d/y)