Original application for homestead and related tax exemptions




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DR-501

R. 12/14


Rule 12D-16.002

F.A.C.


Eff. 12/14

Provisional


ORIGINAL APPLICATION FOR HOMESTEAD


AND RELATED TAX EXEMPTIONS
Permanent Florida residency required on January 1.

Application due to property appraiser by March 1.



County      

Tax Year      

Parcel ID      

I am applying for homestead exemption, $25,000 to $50,000  New  Change

Do you claim residency in another county or state? Applicant?  Yes  No Co-applicant?  Yes  No




Applicant

Co-applicant/Spouse

Name

     

     

*Social Security #

     

     

Immigration #

     

     

Date of birth

     

     

% of ownership

     

     

Date of permanent residency

     

     

Marital status  Single  Married  Divorced  Widowed

Homestead address

     


Mailing address, if different

     


Legal description

     


Phone      

Type of deed       Date of deed      

Recorded: Book       Page       Date      

Did any applicant receive or file for exemptions last year?  Yes  No

Previous address:      




Please provide as much information as possible. Your county property appraiser will make the final determination.

Proof of Residence

Applicant

Co-applicant/Spouse

Previous residency outside Florida and date terminated

      date      

      date      

FL driver license or ID card number

      date      

      date      

Evidence of relinquishing driver license from other state

     

     

Florida vehicle tag number

     

     

Florida voter registration number (if US citizen)

      date      

      date      

Declaration of domicile, enter date

      date      

      date      

Current employer

     

     

Address on your last IRS return


     

     

School location of dependent children

     

     

Bank statement and checking account mailing address

     

     

Proof of payment of utilities at homestead address

 Yes  No

 Yes  No

Name and address of any owners not residing on the property

     

* Disclosure of your social security number is mandatory. It is required by section 196.011(1)(b), Florida Statutes. The social security number will be used to verify taxpayer identity and homestead exemption information submitted to property appraisers.

Continued on page 2

DR-501

R. 12/14


Page 2


In addition to homestead exemption, I am applying for the following benefits.

See page 3 for qualification and required documents.



By local ordinance only:

 Age 65 and older with limited income (amount determined by ordinance)

 Age 65 and older with limited income and permanent residency for 25 years or more

 $500 widowed  $500 blind  $500 totally and permanently disabled

 Total and permanent disability - quadriplegic

 Certain total and permanent disabilities - limited income and hemiplegic, paraplegic, wheelchair required, or legally blind

 Disabled veteran discount, 65 or older

 Veteran disabled 10% or more

 Disabled veteran confined to wheelchair, service-connected

 Service-connected totally and permanently disabled veteran or surviving spouse

 Surviving spouse of veteran who died while on active duty

 Surviving spouse of first responder who died in the line of duty

Other, specify:      

I authorize this agency to obtain information to determine my eligibility for the exemptions applied for. I qualify for these exemptions under Florida Statutes. I own the property above and it is my permanent residence or the permanent residence of my legal or natural dependent(s). (See s. 196.031, F.S.)

I understand that under section 196.131(2), Florida Statutes, any person who knowingly and willfully gives false information to claim homestead exemption is guilty of a misdemeanor of the first degree, punishable by imprisonment up to one year, a fine up to $5,000, or both.

Under penalties of perjury, I declare that I have read the foregoing application and the facts in it are true.


Signature, applicant Signature, co-applicant

Date       Phone       Date       Phone      
                       

Signature, property appraiser or deputy Date Entered by Date


Penalties

The property appraiser has a duty to put a tax lien on your property if you received a homestead exemption during the past 10 years that you were not entitled to. The property appraiser will notify you that taxes with penalties and interest are due. You will have 30 days to pay before a lien is recorded. If this was not an error by the property appraiser, you will be subject to a penalty of 50 percent of the unpaid taxes and 15 percent interest each year (see s. 196.011(9)(a), F.S.). For special requirements for estates probated or administered outside Florida, see s. 196.161(1), F.S.

The information in this application will be given to the Department of Revenue. Under s. 196.121, F.S., the Department and property appraisers can give this information to any state where the applicant has resided. Social security numbers will remain confidential under s.193.114(5), F.S.
Contact your local property appraiser or

visit the Department of Revenue’s website at http://dor.myflorida.com/dor/property/



E
DR-501

R. 12/14


Page 3

XEMPTION AND DISCOUNT REQUIREMENTS



Homestead Every person who owns real property in Florida on January 1, makes the property his or her permanent residence or the permanent residence of a legal or natural dependent, and files an application may receive a property tax exemption up to $50,000. The first $25,000 applies to all property taxes. The added $25,000 applies to assessed value over $50,000 and only to non-school taxes.

Your local property appraiser will determine whether you are eligible. The appraiser may consider information such as the items requested on the bottom of page 1.



Save our Homes (SOH) Beginning the year after you receive homestead exemption, the assessment on your home cannot increase by more than the lesser of the change in the Consumer Price Index or 3 percent each year, no matter how much the just value increases. If you have moved from one Florida homestead to another within the last two years, you may be eligible to take some of your SOH savings with you. See your property appraiser for more information.

This page does not contain all the requirements that determine your eligibility for an exemption.

Consult your local property appraiser and Chapter 196, Florida Statutes, for details.

Added Benefits Available for Qualified Homestead Properties




Amount

Qualifications

Forms and Documents*

Statute

Exemptions

Local option, age 65 and older

Determined by local ordinance

Local ordinance, limited income

Proof of age

DR-501SC, household income



196.075

The amount of the assessed value

Local ordinance, just value under $250,000, permanent residency for 25 years or more.

DR-501SC, household income

Widowed

$500




Death certificate of spouse

196.202

Blind

$500




Florida physician, DVA*, or SSA**

196.202

Totally and Permanently Disabled

$500

Disabled

Florida physician, DVA*, or SSA**

196.202




All taxes

Quadriplegic

2 Florida physicians or DVA*

196.101




All taxes

Hemiplegic, paraplegic, wheelchair required for mobility, or legally blind

Limited income



DR-416, DR-416B, or

letters from 2 FL physicians


(For the legally blind, one can be an optometrist.)

Letter from DVA*, and


DR-501A, household income

196.101

Veterans and First Responders Exemptions and Discount

Disabled veteran discount, age 65 and older

% of disability

Combat-related disability

Proof of age, DR-501DV

Proof of disability, DVA*, or


US government

196.082

Veteran, disabled 10% or more by misfortune or during wartime service

Up to $5,000

Veteran or surviving spouse of at least 5 years

Proof of disability, DVA*, or
US government

196.24

Veteran confined to wheelchair, service-connected, totally disabled

All taxes

Veteran or surviving spouse

Proof of disability, DVA*, or
US government

196.091

Service-connected, totally and permanently disabled veteran or surviving spouse

All taxes

Veteran or surviving spouse

Proof of disability, DVA*, or
US government

196.081

Surviving spouse of veteran who died while on active duty

All taxes

Surviving spouse

Letter attesting to the veteran’s death while on active duty

196.081

Surviving spouse of first responder who died in the line of duty

All taxes

Surviving spouse

Letter attesting to the first responder’s death in the line of duty

196.081

Department of Revenue (DR) forms are available at http://dor.myflorida.com/dor/property/forms/.

*DVA is the US Department of Veterans Affairs or its predecessor.**SSA is the Social Security Administration.






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