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DR-501
Rule 12D-16.002,
ORIGINAL APPLICATION FOR HOMESTEAD F.A.C.
Effective 11/23
AND RELATED TAX EXEMPTIONS Page 1 of 4
Permanent Florida residency required on January 1.
Application due to property appraiser by March 1.
County Select County Tax Year
I am applying for homestead exemption 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
Parcel identification number or legal description Applicant Phone
Co-applicant Phone
Type of deed Date of deed
Recorded: Book Page Date or Instrument number
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
date date
and date terminated
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
date date
US citizen)
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
Yes No Yes No
homestead address
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.
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