Fillable Florida Department of Revenue - DR501 Original Application for Homestead and Related Tax Exemptions

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Florida Department of Revenue - DR501 Original Application for Homestead and Related Tax Exemptions

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ORIGINAL APPLICATION FOR HOMESTEAD
AND RELATED TAX EXEMPTIONS
Permanent Florida residency required on January 1.
Application due to property appraiser by March 1.
*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
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
Marital status Single Married Divorced Widowed
Homestead address
Mailing address, if different
Legal description
Phone
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
and date terminated
date
date
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
US citizen)
date
date
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
homestead address
Yes No
Yes No
Name and address of any owners not residing on the property
DR-501
Rule 12D-16.002,F.A.C
Eff. 09/18
Page 1 of 4
Select County
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)
Age 65 and older with limited income and permanent residency for 25 years or more
$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
Disabled veteran confined to wheelchair, service-connected
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
Surviving spouse of first responder who died in the line of duty
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.
I certify all information on this form and any attached statements, schedules, etc., are true and correct to
the best of my knowledge as of January 1 of this year.
___________________________________________ ___________________________________
Signature, applicant Signature, co-applicant
Date Date
File the signed application for exemption with the county property appraiser.
________________ ________
Signature, property appraiser or deputy Date Entered by Date
Penalties
The property appraiser has a duty to put a tax lien on your property if you received a homestead
exemption during the past 10 years that you were not entitled to. The property appraiser will notify you
that taxes with penalties and interest are due. You will have 30 days to pay before a lien is recorded. If
this was not an error by the property appraiser, you will be subject to a penalty of 50 percent of the unpaid
taxes and 15 percent interest each year (see s. 196.011(9)(a), F.S.). For special requirements for estates
probated or administered outside Florida, see s. 196.161(1), F.S.
The information in this application will be given to the Department of Revenue. Under s. 196.121, F.S.,
the Department and property appraisers can give this information to any state where the applicant has
resided. Social security numbers will remain confidential under s.193.114(5), F.S.
Contact your local property appraiser if you have questions about your exemption.
DR-501
Eff. 09/18
Page 2 of 4
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EXEMPTION AND DISCOUNT REQUIREMENTS
Homestead Every person who owns real property in Florida on January 1, makes the property his or her permanent
residence or the permanent residence of a legal or natural dependent, and files an application may receive a property tax
exemption up to $50,000. The first $25,000 applies to all property taxes. The added $25,000 applies to assessed value over
$50,000 and only to non-school taxes.
Your local property appraiser will determine whether you are eligible. The appraiser may consider information such as the
items requested on the bottom of page 1.
Save our Homes (SOH) Beginning the year after you receive homestead exemption, the assessment on your home cannot
increase by more than the lesser of the change in the Consumer Price Index or 3 percent each year, no matter how much
the just value increases. If you have moved from one Florida homestead to another within the last two years, you may be
eligible to take some of your SOH savings with you. See your property appraiser for more information.
This page does not contain all the requirements that determine your eligibility for an exemption.
Consult your local property appraiser and Chapter 196, Florida Statutes, for details.
Added Benefits Available for Qualified Homestead Properties
Amount
Qualifications
Forms and Documents*
Statute
Exemptions
Local option, age 65 and older
Determined by
local ordinance
Local ordinance, limited
income
Proof of age
DR-501SC, household income
196.075
The amount of the
assessed value
Local ordinance, just value
under $250,000, permanent
residency for 25 years or
more.
DR-501SC, household income
Widowed
$500
Death certificate of spouse
196.202
Blind
$500
Florida physician, DVA*, or SSA**
196.202
Totally and Permanently Disabled
$500
Disabled
Florida physician, DVA*, or SSA**
196.202
All taxes
Quadriplegic
2 Florida physicians or DVA*
196.101
All taxes
Hemiplegic, paraplegic,
wheelchair required for
mobility, or legally blind
Limited income
DR-416, DR-416B, or
letters from 2 FL physicians
(For the legally blind, one can be an
optometrist.)
Letter from DVA*, and
DR-501A, household income
196.101
Veterans and First Responders Exemptions and Discount
Disabled veteran discount, age 65
and older
% of disability
Combat-related disability
Proof of age, DR-501DV
Proof of disability, DVA*, or
US government
196.082
Veteran, disabled 10% or more
by misfortune or during wartime
service
Up to $5,000
Veteran or surviving spouse
Proof of disability, DVA*, or
US government
196.24
Veteran confined to wheelchair,
service-connected, totally disabled
All taxes
Veteran or surviving spouse
Proof of disability, DVA*, or
US government
196.091
Service-connected, totally and
permanently disabled veteran or
surviving spouse
All taxes
Veteran or surviving spouse
Proof of disability, DVA*, or
US government
196.081
Surviving spouse of veteran who
died while on active duty
All taxes
Surviving spouse
Letter attesting to the veteran’s
death while on active duty
196.081
First responder totally and
permanently disabled in the line
of duty or surviving spouse
All Taxes
First responder or surviving
spouse
Proof of Disability, employer
certificate, physician’s certificate
and SSA** (or additional physician
certificate)
196.102
Surviving spouse of first
responder who died in the line of
duty
All taxes
Surviving spouse
Letter attesting to the first
responder’s death in the line of duty
196.081
*DVA is the US Department of Veterans Affairs or its predecessor. **SSA is the Social Security Administration.
DR-501
Eff. 09/18
Page 3 of 4
References
This form mentions the following documents, which are incorporated by reference in Rule 12D-16.002,
F.A.C. The forms may be available on your county property appraiser’s website
or the Department of Revenue’s website at http://floridarevenue.com/property/Pages/Forms.aspx.
Form Form Title
DR-416 Physician’s Certification of Total and Permanent Disability
DR-416B Optometrist’s Certification of Total and Permanent Disability
DR-501A Statement of Gross Income
DR-501DV Application for Homestead Tax Discount, Veterans Age 65 and Older with a
Combat-Related Disability
DR-501SC Adjusted Gross Household Income, Sworn Statement and Return
DR-501
Eff. 09/18
Page 4 of 4
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Florida Department of Revenue - DR501 Original Application for Homestead and Related Tax Exemptions

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Completed 26 May 2020

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