Please read the instructions on the back of this form before you complete it. The applicant must be 100% disabled by or be receiving
100% compensation for service-connected injuries on Jan. 1 of the year for which the exemption is sought. See instructions for ling a late
application on page 2 of this form.
Current application Late application for prior year
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 Surviving spouse Yes No
Name of spouse
Home address
County in which home is located
Taxing district and parcel or registration number
Were you discharged or released from active duty under honorable conditions? You will need to provide a copy of your Department of
Defense Form 214 (DD214).
Yes No
In order to be eligible for the enhanced disabled veteran 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
I am applying as:
A veteran with a total disability rating. Attach a copy of the veteran’s DD214 and the award letter showing the disability rating of 100%.
A veteran with a total disability rating for compensation based on individual unemployability. Attach a copy of the veteran’s DD214, the
award letter showing compensation at 100%, and a document showing the approval of the application for a determination of individual
unemployability.
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
I declare under penalty of perjury that (1) I occupied this property as my principal place of residence on Jan. 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) the documen-
tation presented regarding my disability and my discharge or release has been received from the Department of Veterans Affairs or its
predecessor or successor agency, and (5) I have examined this application, and to the best of my knowledge and belief, this application
is true, correct and complete.
Signature of applicant Date
Mailing address
Phone number E-mail address
DTE 105I
Rev. 9/16
Homestead Exemption Application for
Disabled Veterans and Surviving Spouses
Real property: File with the county auditor on or before Dec. 31.
Manufactured or mobile homes: File with the county auditor on or before the rst Monday in June.
from tax bill or available from county auditor
- 1 -
Mike Kovack, Medina County Auditor
144 North Broadway Street
Medina, OH 44256
(330) 725-9754 (844) 722-3800
www.medinacountyauditor.org
Please read before you complete the application.
What is the Homestead Exemption for Disabled Veterans?
The homestead exemption provides a reduction in property taxes
to quali ed disabled veterans, or a surviving spouse, on the dwell-
ing 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 $50,000 of the market value of an eligible taxpayer’s home-
stead.
What Your Signature Means: By signing the front of this form,
you af 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 the documentation you have presented
is genuine and was received from the Department of Veterans Af-
fairs, its predecessor or successor.
Quali cations for the Homestead Exemption for Real Prop-
erty and Manufactured or Mobile Homes: To receive the home-
stead exemption you must (1) have been discharged or released
from active duty, (2) be determined to have a total service-related
disability or be receiving compensation for a service-related dis-
ability at a level of 100% following a determination of individual
unemployability by the Department of Veteran’s Affairs or its pre-
decessor or successor, or be a surviving spouse (see de nition
at right), (3) have been discharged or released under honorable
conditions, and (4) own and have occupied your home as your
principal place of residence on January 1 of the year in which you
le the application. A person only has one principal place of resi-
dence; your principal place of residence determines, among other
things, where you are registered to vote and where you declare
residency for income tax purposes. If the property is being pur-
chased under a land contract, is owned by a life estate or by a
trust, or the applicant is the mortgagor 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.
De nition of a Surviving Spouse: An eligible surviving spouse
must (1) be the surviving spouse of a person who was receiv-
ing the homestead exemption for the year in which the death oc-
curred, (2) must have occupied the homestead at the time of the
veteran’s death and (3) must acquire ownership of the homestead
or, in the case of a homestead that is a unit in a housing coop-
erative, continue to occupy the homestead. The surviving spouse
remains eligible for the exemption until the year following the year
in which the surviving spouse remarries.
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.
Quali ed Disabled Veteran: In order to qualify for the exemption
you must be a veteran of the armed forces of the United States,
including reserve components thereof, or of the National Guard,
who has been discharged or released from active duty under hon-
orable conditions, and who has received a total disability rating
(100%) or a total disability rating for compensation (100%) based
on individual unemployability, for a service-connected disability or
combination of service-connected disabilities.
- 2 -
DTE 105I
Rev. 9/16
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
VA documentation veri ed Yes No Request Granted Denied
County auditor (or representative) Date
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