Fill - Free fillable Alan Harold Disabled Persons and Surviving Spouses Stark (Stark County Government) PDF form

FOR COUNTY AUDITOR’S USE ONLY:

Taxing district and parcel or registration number Auditor’s application number

First year for homestead exemption

Dateled

Name on tax duplicate

Taxable value of homestead: Taxable land Taxable bldg. Taxable total

Method of Verication (must complete one):

Tax commissioner portal: Year Total MAGI No information returned

Ohio tax return (line 3 plus line 11 of Ohio Schedule A): Year Total MAGI

Federal tax return (line 4, 1040EZ): Year Total FAGI

(line 21, 1040A): Year Total FAGI

(line 37, 1040): Year Total FAGI

Worksheet (attached): Estimated MAGI

Granted Denied

County auditor (or representative) Date

DTE 105A

Rev. 10/19

Homestead Exemption Application for Senior Citizens,

Disabled Persons and Surviving Spouses

Real property and manufactured or mobile homes: File with the county auditor on or before December 31.

Please read the instructions on the back of this form before you complete it. Disabled applicants must complete form DTE 105E,

CerticateofDisabilityfortheHomesteadExemption,andattachitoraseparatecerticationofdisabilitystatusfromaneligiblestateor

federal agency to this application. See the instructions on page 3 of this form.

Current application

Late application for prior year

Application of person who received homestead reduction for 2013 or for 2014 for manufactured or mobile homes. Form DTE 105G

must accompany this application.

Application of person who received the homestead reduction for 2006 that is greater than the reduction calculated under the current law.

Form DTE 105G must accompany this application.

Type of application:

Senior citizen (must be at least age 65 by December 31st of the year for which the exemption is sought)

Disabled person (must be permanently and totally disabled on January 1 of the year for which exemption is sought)

Surviving spouse (must have been at least 59 years old on the date of the spouse’s death and must meet all other homestead exemp-

tion requirements)

Type of home:

Single family dwelling Unit in a multi-unit dwelling Condominium Unit in a housing cooperative

Manufactured or mobile home Land under a manufactured or mobile home

Applicant’s name Applicant’s date of birth SSN

Name of spouse Spouse’s date of birth SSN

Homeaddress

County in which home is located

Taxing district and parcel or registration number

from tax bill or available from county auditor

- 1 -

Stark County Office Building

110 Central Plaza South, Suite 220

Canton, OH 44702-1410

Phone (330) 451-7323

Fax (330) 451-7630

Email jamaag@starkcountyohio.gov

Alan Harold

Stark County Auditor

Reset Form

Inordertobeeligibleforthehomesteadexemption,theformofownershipmustbeidentied.Propertythatisownedbyacorporation,

partnership, limited liability company or other legal entity does not qualify for the exemption. Check the box that applies to this property.

The applicant is:

an individual named on the deed

a purchaser under a land installment contract

a life tenant under a life estate

a mortgagor (borrower) for an outstanding mortgage

trustee of a trust with the right to live in the property

the settlor, under a revocable or irrevocable inter vivos trust, holding title to a homestead occupied by the settlor as a right under the

trust

astockholderinaqualiedhousingcooperative.SeeformDTE105A–Supplementforadditionalinformation.

other

If the applicant or the applicant’s spouse owns a second or vacation home, please provide the address and county below.

Address City State ZIPcode County

HaveyouordoyouintendtoleanOhioincometaxreturnforlastyear?YesNo

Total income for the year preceding year of application, if known (see instructions):

I declare under penalty of perjury that (1) I occupied this property as my principal place of residence on January 1 of the year(s) for which

I am requesting the homestead exemption, (2) I currently occupy this property as my principal place of residence, (3) I did not acquire

this homestead from a relative or in-law, other than my spouse, for the purpose of qualifying for the homestead exemption, (4) my total

income for myself and my spouse for the preceding year is as indicated above and (5) I have examined this application, and to the best

of my knowledge and belief, this application is true, correct and complete.

I (we) acknowledge that by signing this application, I (we) delegate to both the Ohio tax commissioner and to the auditor of the county in which the

propertyforwhichIamseekingexemptionislocated,andtotheirdesignatedagents,theauthoritytoreleasemytaxand/ornancialrecordsand

to examine and consult regarding such records for the purpose of determining my eligibility for the homestead exemption or a possible violation of

thehomesteadlaws.SuchrecordsshallnotcontainanyfederaltaxinformationasdenedinI.R.C.6103andreceivedfromtheInternalRevenue

Service.IexpresslywaivethecondentialityprovisionsoftheOhioRevisedCode,includingO.R.C.5703.21and5747.18,whichmayotherwise

prohibit disclosure, and agree to hold the Ohio tax commissioner and county auditor harmless with respect to the limited disclosures herein. Except

asauthorizedbylaw,thepartiestowhichthisauthorityisdelegatedshallmaintainthecondentialityoftheinformationreceivedandtheinformation

shall not otherwise be re-disclosed.

Signature of applicant Signature of spouse

Mailing address Date

Phonenumber E-mailaddress

DTE 105A

Rev. 10/19

- 2 -

DTE 105A

Rev. 10/19

Please read before you complete the application.

What is the Homestead Exemption? The homestead exemp-

tionprovidesareductioninpropertytaxestoqualiedsenioror

disabled citizens, or a surviving spouse, on the dwelling that is that

individual’s principal place of residence and up to one acre of land

of which an eligible individual is an owner. The reduction is equal

to the taxes that would otherwise be charged on up to $25,000 of

the market value of an eligible taxpayer’s homestead.

What Your Signature Means: By signing the front of this form,

you arm under penalty of perjury that your statements on the

form are true, accurate and complete to the best of your knowl-

edge and belief and that you are authorizing the tax commissioner

andthecountyauditortoreviewnancialandtaxinformationled

with the state. A conviction of willfully falsifying information on this

application will result in the loss of the homestead exemption for a

period of three years.

Qualications for the Homestead Exemption for Real Property

and Manufactured or Mobile Homes: To receive the homestead

exemption you must be (1) at least 65 years of age during the

yearyourstle,orbedeterminedtohavebeenpermanentlyand

totallydisabled(seedenitionatright),orbeasurvivingspouse

(seedenitionatright),and(2)ownandhaveoccupiedyourhome

as your principal place of residence on Jan. 1 of the year in which

youletheapplication.Formanufacturedormobilehomeowners,

thedatesapplytotheyearfollowingtheyearinwhichyoulethe

application. A person only has one principal place of residence;

your principal place of residence determines, among other things,

where you are registered to vote and where you declare residency

for income tax purposes. You may be required to present evidence

of age. If the property is being purchased under a land contract,

is owned by a life estate or by a trust, or the applicant is the mort-

gagor of the property, you may be required to provide copies of

any contracts, trust agreements, mortgages or other documents

that identify the applicant’s eligible ownership interest in the home.

If you are applying for homestead and did not qualify for the ex-

emption for 2013 (2014 for manufactured homes), your total in-

come cannot exceed the amount set by law. Beginning tax year

2020 for real property and tax year 2021 for manufactored homes,

“total income” is dened as “modied adjusted gross income,”

which is comprimised of Ohio Adjusted Gross Income plus busi-

ness income from line 11 of Schedule A of the Ohio Schedule A.

“Total Income” is that of the owner and the owner’s spouse for the

year preceding the year for which you are applying. If you do not

leanOhioincometaxreturn,youwillbeaskedtoproduceafed-

eralincometaxreturnforyouandyourspouse.Ifyoudonotlea

federal income tax return, you will be asked to produced evidence

of income and deductions allowable under Ohio law so that the

auditormayestimateOhiomodiedadjustedgrossincome.

Current Application: If you qualify for the homestead exemption

forthersttimethisyear(forrealproperty)orforthersttimenext

year (for manufactured or mobile homes), check the box for Current

Application on the front of this form.

Late Application: Ifyoualsoqualiedforthehomesteadexemption

for last year (for real property) or for this year (for manufactured or

mobilehomes)onthesamepropertyforwhichyouarelingacur-

rentapplication,butyoudidnotleacurrentapplicationforthatyear,

youmaylealateapplicationforthemissedyearbycheckingthe

lateapplicationboxonthefrontofthisform.Youmayonlylealate

application for the same property forwhichyouare ling a current

application.

Denition of a Surviving Spouse: An eligible surviving spouse

must (1) be the surviving spouse of a person who was receiving

the homestead exemption by reason of age or disability for the

year in which the death occurred, and (2) must have been at least

59 years old on the date of the decedent’s death.

Permanent Disability: Permanentandtotallydisabledmeansa

personwhohas,ontherstdayofJanuaryoftheyearforwhich

the homestead exemption is requested, some impairment of body

ormindthatmakeshim/herunttoworkatanysubstantiallyremu-

nerative employment which he/she is reasonably able to perform

andwhichwill,withreasonableprobability,continueforaninde-

nite period of at least 12 months without any present indication

- 3 -

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