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Kev 10-08 APPLICATION FOR HOMESTEAD EXEMPTION The bon1t:stead ex.emptions provided for in this Applica.tioo form are those iuthonzed by Georgia law. Cou11tiesa re authorized to provide for locaJ homestead ex.emptions that may vary from the ones shown on this application. Applicants seeking a local homestead exemption should contact the local Tax Commissioner or Tax Receiver for additional information. If this Иlication is denied an Йpeal may be filed in accordance with O.C.G.A 48-5-311. 7' 0 - ; , - O •L 6- 7- • 0 • - ' SECTION A: APPLICANT lNFORMA TlON !List below the adcln:ss of any other property where you or your spouse have applied for and been granted a homestead exemption for the current year: Are you and your spouse a Georgia resident, US citizen or non-citizen with legal authorization from the US Immigration and Naturalization Service? 0 YES D NO lfyou an: a non-citizen with legal authorization from the US Immigration and Naturalization Service, please provide your Legal Alien Registration# Applicant Name: Spouse: Name: , • Street Address: ;;iJ'f?if Street Address: . , , • . О•-I ' , • ; • City State Zip· Jt.l 1 ·К(ЛJМНj City State Zip· . .ll:i ' . • I • . I • :"1;'#:ПР111:, Year of Birth: I PhomС Number: :УФХ! Year of Birth: I Phone Number: · · f . . . i•Ц jl,, Counly where you are registered to vote: ЧШ!llЩW@:Ъ County where you are .registered to vote: • County where car is registered: I lfyou and/or your spouse are in the military service, list the state shown as your home ofrecord: U'you answer Yes to Question# L, please follow the instructions to determine if you qualify for an increased homestead amount. Please see the Tax Commissioner or Receiver for additional information and qualification requirements_._ YES ! J. Were you or your spouse age 62 or older as of Jan 1 of the year of this application? Go to Sections CI and/or C2 on the back of this application to determine whether you meet certain gross and/or net income requirements . . J YES 12. Is the applicant or spouse a I 00% disabled veteraЫor is Jhe ae_plicailt the unremarried surviving spouse of a 100% disabled veteran? -1 YES Are }'_DLI the unremarried surviving spouse of a US service member killed in action? D Y ESj4. An: you lhe unremarried surviving s,e_ouse of a firefighter ()_l"_peac_e offic_er in the line of duty? S.ECTJ0N B: Loc11tioJ1_0_[ Property (Stn:Ьt Address): Date Property Purchased: I From Whom Purchased: PROPERTY INFORMATION Lot Size or Number of Acres: Map/Parcel Number: Price: I Amount of Lien: Land Lo.t Number: lLand District Number: Kind o: fTitle Hdcl: ITo Whom is Lien due: Ls any part of the property used for business purposes? D YES -0 NO lf yes, what kind of business & how much of the eropeity is used? Deed Recorded: Book: ls any part o:f the property rented? LJ Ifjes, what part ls rented? Page: YES NO AFFIDAVIT OF APPLICANT I, the undi;;rnigned, do solemnly swear that the statements made in support of this application are true and correct, that I am the bona fide owner of the property described in thiЭ applkation, that I shall occupy or actually occupied same on Jan I of the year for which application is made, that I am an eligible applicant for the homestead exemption applied for, 4ualitying or rm:eting the definition of the word "applicant" as defined in O.C.G.A. § 48-5-40 and that no transaction has been made in collusion with another for the purpose ur obtaining a homestead exemption contrary to law. Sworn to and subscribed to before me this day of , 20___ Applicant's Signature: _ Tc1x Commissioner or Tax Receiver f ] ЮPPROVED [ ] DENIED Board of Tax Assessors Date THIS SECTION FOR TAX ASSESSORS USE ONLY: STATE TAX>> SCHOOL TAX>> CODE AMOUNT ::ii1Jn.1iJ- • ,r