In Lieu of: 62A350 (12-11) PIDN:__________________________________________
of K
Application for Exemption
DEPARTMENT OF REVENUE Under the Homestead / Disability Amendment
HEX ______ DEX ______
Please print or type all requested information
County___________________________________________ Date Submitted ____/____/________
Application is hereby made for the homestead exemption provided by Section 170 of the Kentucky Constitution.
1. Name(s) of owner-applicant(s) in whose name(s) title is vested: ___________________________________________________
2. Name of applicant(s) Date of birth Age Sex Relationship to other occupants
_________________________________ ____/_____/______ ______ _____ Husband____ Wife____ Other ________
_________________________________ ____/_____/______ ______ _____ Husband____ Wife____ Other ________
3. Address of personal residence: __________________________________________________________________________
City ___________________________ State ______ Zip Code _________________
Mailing address (if different from above) __________________________________________________________________
Phone Number __________________________ Date of Ownership ____/____/________
4. Have you ever applied for, or are you receiving, the homestead exemption in different location, county or state?
____yes ____no If “yes”, where? _____________________________________________________________
5. Type of residential unit: ____ single family residence ____ duplex ____ apartment building ____ mobile home ____ condominium
____ other (description) _______________________________________________________
Note: Amount of exemption: If ownership is fee simple, equitable title, jointly with survivorship or jointly in common, applicant receives full exemption or up to the
assessed value of his interest in the property, whichever is less. If ownership is by stock ownership or membership, the amount of exemption is full exemption
or the percentage that the applicant’s ownership bears to the total value of the property. (Example: Total value of the stru
cture = $50,000; applicant’s stock
ownership = 10%; exemption limit = $5,000.)
I, _________________________________________________, hereby swear (affirm) under penalty of perjury that I (we) am (are) the owner(s)
of the property for which this assessment exemption is sought and that I (we) do not or will not claim an exemption for any other property in this
Commonwealth or another state. I further swear (affirm) that I (we) maintain this residential unit as my (our) primary residence; that I (we) am
(are) 65 years of age or over, or totally disabled; and that all information contained in this application is true and correct.
If qualifying under the disability provision under KRS 132.810(2), I do further swear (affirm) under penalty of perjury that my disability is
continuing and that if my disability status changes and benefits are no longer received I shall report such changes to the property valuation
administrator ’s office as required by KRS 132.810(4)(b). Failure to do so could result in supplemental bills being issued for the amount of the
exemption received for up to a period of five years.
_____________________________ ___/___/____ __________________________ __________
Signature of Applicant Date Signature of Spouse Date
__________________________________________ _____/____/______ Application is: _____ approved ______ denied
Property Valuation Administrator / Deputy Date
PVA DAT _______ SF_______ Exoneration _______
(See Reverse side for explanation)
Return form via mail/fax/email
303 Court St. Rm. 210
Covington, KY 41011
859-392-1770 (fax)
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Date Modified 5/9/2018
1. This application-affidavit must be submitted by December 31st of the year in which exemption is sought for residential property located
in Kenton County to the Kenton County Property Valuation Administrator (PVA). In addition, the applicant must own, occupy and maintain
the subject property as a taxable interest as of January 1 during the tax year for which the exemption is sought (in accordance with KRS
Under KRS 132.810 those applying under the disability provision are required to document their disability only at the time of initial
application. Once approved, annual reapplication is not required. However, applicants are required to report any change in their disability
classification to Kenton County PVA. Failure to do so could result in back taxes, penalties and interest for any years an applicant did not
legally qualify for the exemption.
2. What does Homestead Exemption mean?
The Homestead Exemption results in a reduction in the net taxable value of the owner’s personal residence. The amount of the exemption
is determined by the Legislature every two years. Under the provisions of the Homestead statute, a person or persons must be 65 years of
age or older or totally disabled during the year for which application is made, and must own, occupy and maintain a residential unit for such
3. Age Requirement
A person or persons owning, living in and maintaining a residential unit must meet the 65 years of age requirement. If only one spouse is
65, the age requirement is met.
4. Verification of Age & Kenton County Residence
A person must own and occupy the property for which exemption is sought as his or her primary residence. A primary residence is a
person’s fixed permanent or principal home for legal, voting & tax purposes. Date of birth of the applicant(s) and proof of Kenton County
residence can be verified by submitting a copy of one of the following forms of identification. The address shown on the identification must
match the address of residence for which application is made.
A. Valid Kenton County driver’s license issued by Kenton County Circuit Court Clerk’s Office.
B. Valid personal ID card issued by Kenton County Circuit Court Clerk’s Office.
5. Disability Requirements
A person must be classified as totally disabled under a program authorized or administered by an agency of the United States government
or by any retirement system either within or without the Commonwealth of Kentucky. Applicants must document their disability with a
copy of their award letter from their retirement system/social security that declares the date they became eligible for disability benefits
along with:
A. Documentation of their date of birth.
B. Proof of ownership of their primary residence for which application is made.
C. Applicants must have maintained their disability classification and received disability payments under such classification for the
entire year. (Earning statement or 1099 form.)
6. Review of Applicants
The Kenton County Property Valuation Administrator may, at any time, conduct a review of applications and may require an applicant to re-
apply or submit proof of continuing disability and benefits received.
7. KRS 132.810(2)(h) provides that, “When title to property which is exempted, either in whole or in part, under the Homestead Exemption
is transferred, the owner, administrator, executor, trustee, guardian, conservator, curator or agent shall report such transfer to the
Property Valuation Administrator.”
8. Fraudulent Misrepresentations
Under the provisions of KRS 132.990(1), “Any person who willfully fails to supply the Property Valuation Administrator or the Department
of Revenue with a complete list of his property and such facts with regard thereto as may be required or who violates any of the provisions
of KRS 132.570 shall be fined not more than five hundred dollars ($500).”