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Get FL DR-501 2021-2024

All taxes Proof of age DR-501SC household income 196. 075 Death certificate of spouse 196. 202 Florida physician DVA or SSA Disabled Quadriplegic 196. DR-501 R* 06/17 12DER17-02 Eff* 06/17 ORIGINAL APPLICATION FOR HOMESTEAD AND RELATED TAX EXEMPTIONS Permanent Florida residency required on January 1. Application due to property appraiser by March 1. FOR THE 2017 TAX YEAR the application for first responders injured in the line of duty or a surviving spouse is DUE BY AUGUST 1 2017. County Tax Year Select County Parcel ID I am applying for homestead exemption 25 000 to 50 000 New Do you claim residency in another county or state Yes Applicant Change No Co-applicant Name Social Security Immigration Date of birth of ownership Date of permanent residency Marital status Homestead address Single Married Divorced Widowed Mailing address if different Legal description Type of deed Phone Date of deed Recorded Book Did any applicant receive or file for exemptions last year Page Date Previous address Please provide as much information as possible. Your county property appraiser will make the final determination* Proof of Residence Previous residency outside Florida and date terminated FL driver license or ID card number Evidence of relinquishing driver license from other state Florida vehicle tag number Florida voter registration number if US citizen Declaration of domicile enter 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 date 12/12/12 date 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 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 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 Service-connected totally and permanently disabled veteran or surviving spouse Surviving spouse of veteran who died while on active duty First responder totally and permanently disabled in the line of duty or surviving spouse 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 Florida Statutes. I understand that under section 196. 131 2 F*S* 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.

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