Fillable Homestead Applicaon CR-H OFFICE USE ONLY Type of (Clay County)

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Homestead Applicaon CR-H OFFICE USE ONLY Type of (Clay County)

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BROWSE CLAY COUNTY (MN) FORMS

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Homestead Applicaon
Please read the instrucons for important informaon on due dates and applicaon requirements before compleng this form. The qualifying
occupant or occupants should complete this applicaon. A qualifying occupant is an occupying owner and their spouse (if applicable) or an
occupying relave and their spouse (if applicable).
OFFICE USE ONLY
Applicant Name
Assessment Year
Assessor or Representave’s Signature
Date
Connued
(Rev. 11/20)
CR-H
Secon 1: Homestead Property Informaon
Address of Homestead
City State ZIP Code County
Date Purchased Date Occupied by
Is the property owned by a trust? Yes
No If yes, aach documents showing the ownership interests of the trust.
Are there mulple owners of the property (not including spouses)? Yes
No If yes, please provide the number of owners.
Type of Applicaon o Owner Occupied
o Relave/Residenal
o Relave/Agricultural
Determinaon o Approved
o Denied
Secon 2: Occupant Informaon
Occupant First Name and Middle Inial Occupant Last Name Social Security Number/ITIN
Phone Number Email Address
Occupant’s Mailing Address (if dierent than homestead property)
City State ZIP Code
Are you listed as an owner on the deed? Yes No If yes, do not complete secon 4, Relave Homestead.
Are you a Minnesota resident? Yes No
Marital Status: Single
Married
Divorced
Legally Separated
Widow
Your Previous Address Date Vacated
City State ZIP Code County
Did you claim homestead at your previous address? Yes
No If yes, what happened with your previous homestead
(sold, rented, etc.):
Spouse of Occupant First Name and Middle Inial Spouse of Occupant Last Name Social Security Number/ITIN
Phone Number Email Address
Does the spouse occupy the property listed in Secon 1?
Yes (List their previous address below) No (List their current address below)
Address
City State ZIP Code County
Secon 3: Spouse Informaon
Spouse of Occupant First Name and Middle Inial Spouse of Occupant Last Name Social Security Number/ITIN
Phone Number Email Address
Does the spouse occupy the property listed in Secon 1?
Yes (List their previous address below) No (List their current address below)
Address
City State ZIP Code County
Secon 3a: Addional Spouse Informaon
Occupant First Name and Middle Inial Occupant Last Name Social Security Number/ITIN
Phone Number Email Address
Occupant’s Mailing Address (if dierent than homestead property)
City State ZIP Code
Are you listed as an owner on the deed? Yes No If yes, do not complete secon 4, Relave Homestead.
Are you a Minnesota resident? Yes No
Marital Status: Single Married
Divorced
Legally Separated Widow
Your Previous Address Date Vacated
City State ZIP Code County
Did you claim homestead at your previous address? Yes No If yes, what happened with your previous homestead (sold, rented,
etc.):
Complete sections 2a and 3a ONLY if there are multiple occupying owners not listed in sections 2 or 3. If not, skip these sections.
Section 2a: Additional Occupant Information
Secon 4: Relave Homestead
Complete this section ONLY if you are a qualifying relative applying for homestead. Otherwise, skip to Section 5. If there are
multiple owners, please attach their information separately.
Property Owner
First Name and Middle Inial Property Owner Last Name Your Relaonship to Property Owner
Property Owner Mailing Address
City State ZIP Code County
Phone Number Email Address
Is the property owner a Minnesota resident?
Yes
No
I cerfy that the above informaon is true and correct to the best of my knowledge. Minnesota Statutes, secon 609.41, states that anyone giving
false informaon in order to avoid or reduce their tax obligaons is subject to a ne of up to $3,000 and/or up to one year in prison.
This applicaon must be signed by the occupant and their spouse (if applicable) and returned to the assessor.
Signature of Occupant Date
Signature of Occupant’s Spouse (If Applicable) Date
Signature of Other Occupant (If Applicable) Date
Signature of Other Occupant’s Spouse (If Applicable) Date
Complete enre applicaon and mail along with all required aachments to your assessor.
Secon 5: Signature
ADDITIONAL QUESTIONS THAT MUST BE ANSWERED:
1. Do you have a Minnesota Driver’s License?
YES _____ NO _____ WILL GET _____
Owner/Occupant #1
Driver’s License #: ________________________
If yes, please provide address listed on License: ________________________________________________________________
If you answer no to this question, please explain: ______________________________________________________________
______________________________________________________________________________________________________.
Owner/Occupant #2
Driver’s License #: ________________________
If yes, please provide address listed on License: ________________________________________________________________
If you answer no to this question, please explain: ______________________________________________________________
______________________________________________________________________________________________________.
__________________________________________________________________________________________________________________________
2. Are your cars registered in Minnesota?
YES _____ NO _____ WILL GET _____ Don’t Own Any_____
If you answer no to this question, please explain where and/or why: ______________________________________________
______________________________________________________________________________________________________.
__________________________________________________________________________________________________________________________
3. Do you file Minnesota Income Tax?
YES _____ NO _____ NOT REQUIRED _____
If you answer no to this question, please explain where and/or why: ________________________________________________
_______________________________________________________________________________________________________.
__________________________________________________________________________________________________________________________
4. Are you registered to vote in Minnesota?
YES _____ NO _____ Do not vote_____ If you are registered to vote, you must vote in the city/township where you claim homestead.
__________________________________________________________________________________________________________________________
5. Will any part of this property be rented to others?
YES _____ NO _____
If you answer yes to this question, please explain: ______________________________________________________________
______________________________________________________________________________________________________.
__________________________________________________________________________________________________________________________
6. Do you have additional agricultural property in any of these MN counties: Becker, Clay, Mahnomen, Norman, Otter Tail or Wilkin?
YES _____ NO _____ If you answer yes, please circle all counties affected.
__________________________________________________________________________________________________________________________
Please mail this completed application and any required attachments to:
Clay County Assessor
PO Box 280
Moorhead, MN 56560
Who is Eligible for Homestead?
If you own and occupy your own property, you may be eligible to receive homestead. You must own the property and occupy it as your
primary residence no later than December 1 of the current year to receive homestead for taxes payable next year. For information about the
benets of homestead, please contact your assessor.
How and When to Apply
Complete and mail the application to your assessor within 30 days of establishing homestead, no later than December 15 to be eligible for
homestead in the next tax year.
For manufactured homes, if you do not own the land the home is on, you must submit the application by May 29 to be eligible for homestead
in the current tax year.
You do not have to reapply for each year. The assessor may ask for an updated application at any time.
Each applicant who occupies the property must provide a Social Security Number and sign the form. Spouses of the applicants must also
provide their Social Security Number, even if they do not occupy the property.
What if My Property is Held Under a Trust?
If the property is owned by a trust, the grantor of the trust is considered the owner when completing this application. The assessor may ask for
additional information, including:
• Name and type of trust
• Grantors of the trust
• Signatures of the grantors and date of those signatures
Required Aachments
If any owners or owners’ spouses do not occupy the property, you must provide their names and addresses to the assessor.
The spouse of the occupant must provide their Social Security Number, even if they do not occupy the property.
If there are more than two qualifying occupants, attach another application with the occupant and occupant’s spouse (if applicable) sections
completed..
Individual Tax Idencaon Number (ITIN)/Social Security Number (SSN)
An ITIN can only be used in situations where one spouse has a Social Security number and the other spouse does not. ITINs are not an
acceptable alternative in any other case.
We will not disclose Social Security number(s) you provide on this form to the public, but we may share among government ocials for tax
collection and administration purposes.
What is a Qualifying Relave?
For residential homestead, qualifying relatives include: parent, stepparent, child, stepchild, grandparent, grandchild, brother, sister, uncle,
aunt, nephew, or niece of the owner, by blood or marriage.
For agricultural homesteads qualifying relatives include: grandchild, child, sibling, or parent of the owner of the agricultural property or the
spouse of the owner.
Use of Informaon
The information on this form is required by Minnesota Statutes, section 273.124 to properly identify you and determine if you qualify for
homestead. Your Social Security number is required. If you do not provide the required information, your application will be denied. If you
provide your Social Security number thereafter, the eective date of the homestead classication may be delayed. Your Social Security
number is considered private data for purposes of establishing homestead.
Penales
Making false statements on this application is against the law. Minnesota Statutes, section 609.41, states that anyone giving false information
in order to avoid or reduce their tax obligations is subject to a ne of up to $3,000 and/or up to one year in prison.
If you falsely claim homestead, you may be assessed a penalty equal to in the amount of the additional tax that would have applied to your
property if it had not been considered homestead.
Quesons?
Contact the assessor’s oce for assistance.
Form CR-H Instrucons
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Homestead Applicaon CR-H OFFICE USE ONLY Type of (Clay County)

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Completed 13 February 2021

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