Form Dr-501 - Original Application For Homestead And Related Tax Exemptions
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3DR-501
ORIGINAL APPLICATION FOR HOMESTEAD
R. 01/18
Rule 12D-16.002,
AND RELATED TAX EXEMPTIONS
F.A.C
Eff. 01/18
Permanent Florida residency required on January 1.
Application due to property appraiser by March 1.
County
Select 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
Single
Married
Divorced
Widowed
Marital status
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
date
date
and date terminated
date
FL driver license or ID card number
date
Evidence of relinquishing driver
license from other state
Florida vehicle tag number
Florida voter registration number (if
date
date
US citizen)
date
date
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
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.
Continued on page 2
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