DTE 105G
                                                                         Rev. 11/13

                Addendum to the Homestead Exemption Application for 
                Senior Citizens, Disabled Persons and Surviving Spouses
  For applicants who have previously received the homestead exemption under R.C. 323.152(A)(2)(b). 
Individuals who received the homestead exemption for tax year 2013 (2014 for manufactured and mobile homes) on any 
residence may continue to receive the homestead exemption on another residence within the state without meeting the 
income test currently required for the exemption, if a different residence otherwise meets the qualifi cation of a homestead. 
  
In order to assure that an applicant has previously received the homestead exemption for the aged or disabled, certain 
information must be made available to the county auditor.  

Applicant’s name

Applicant’s current home address

Taxing district and parcel or registration number of current home

County in which prior homestead was granted

Address for which prior homestead was granted

Taxing district and parcel or registration number of prior home

I declare under penalty of perjury that I was receiving the homestead exemption for tax year 2013 (2014 for manufactured 
and mobile homes) on the property described in this addendum, and have examined this document and, to the best of my 
knowledge and belief, it is true, correct and complete.

Signature of applicant                                     Date

Mailing address

Phone number                                               E-mail address