ANOKA COUNTY APPLICATION FOR HOMESTEAD

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YEAR __________          ID # ____________________________

                  ANOKA COUNTY APPLICATION FOR HOMESTEAD
        Anoka County Property Records and Taxation, 2100 3rd Ave., Room 119, Anoka, MN 55303
                     Read the back of this application before filling in the information below. PLEASE PRINT!!
                        This application must be COMPLETELY filled out. Please ask if you have questions.
APPLICANT DATA (To be completed by owners or parties residing in the home)
LAST NAME OF OCCUPANT                          FIRST NAME                      MIDDLE INITIAL    WORK PHONE


PROPERTY ADDRESS                               CITY                   STATE                ZIP   HOME PHONE


APPLICANT MARITAL STATUS
                                  LEGALLY              DIVORCE                                           OTHER (please indicate below)
   SINGLE        MARRIED        SEPARATED         PENDING IN COURT            DIVORCED

     DATE
   OCCUPIED          DATE OF DEED        PURCHASE PRICE           CONVEYANCE TYPE (attach deed to application and check conveyance type)

                                                                     WARRANTY DEED               CONTRACT FOR DEED                 OTHER

                                          DO YOU
    PLEASE PRINT NAMES OF                OCCUPY?         PREVIOUS ADDRESS FOR OCCUPYING OWNER(S) OR                    SOCIAL SECURITY
            ALL OWNERS                 YES   NO         CURRENT ADDRESS FOR NON-OCCUPYING OWNER(S)                          NUMBER(S)




    IF NO, Are you a co-signer?         Yes       No

          IF OWNERS ARE RELATED AND APPLYING FOR RELATIVE HOMESTEAD, PLEASE INDICATE RELATIONSHIP
                                       DO YOU
    PLEASE PRINT NAME(S) OF           OCCUPY?         RELATION-       QUALIFYING RELATIVE’S PREVIOUS                 SOCIAL SECURITY
    QUALIFYING RELATIVE(S)            YES   NO          SHIP                        ADDRESS                              NUMBER(S)




 IF YOU ARE STILL LEGALLY MARRIED BUT LIVING APART FROM YOUR SPOUSE, THE FOLLOWING INFORMATION MUST BE
                                                 PROVIDED
NAME OF SPOUSE                                   COMPLETE ADDRESS                                                PHONE NUMBER



REASON FOR LIVING APART                                           DOES YOUR SPOUSE HOMESTEAD THE
                                                                  PROPERTY LISTED ABOVE OR ANY OTHER?                 YES            NO

ARE YOU A FIRST TIME HOME-BUYER?                        YES               NO

I/we have read and understand the qualifications on the back of this application. I/we declare to the best of my/our knowledge the
information contained on this application is complete, true and correct.

                                                                      SIGNATURE OF ADDITIONAL
      OWNER(S)/APPLICANT(S) SIGNATURE                             OWNER(S)/OCCUPANT(S) (IF APPLICABLE)                             DATE




                              Please attach a copy of the deed to the property to this form.
                                                                                                                            Updated: 11/03/2006
How to apply                               occupying the property and each              Minnesota Statutes, section 609.41
To apply for the homestead                 owner’s spouse that occupies the             states that anyone giving false
classification for your residence, you     property to be listed on this                information in order to avoid or reduce
must fill out this application. To         application.                                 their tax obligations is subject to a fine
qualify for the homestead                                                               of up to $3,000 and/or up to one year
classification, you must: (All three       Additionally, each owner’s spouse            in prison.
must apply.)                               who occupies the property also must
                                           be listed on the homestead application       In addition, the property owner may be
    1. Be one of the owners of             even if the owner’s spouse is not listed     required to pay all tax which is due on
       the property listed on this         as an owner on the deed of record.           the property based on its correct
       application.                                                                     property class, plus a penalty.
    2. Occupy the property listed          If there is not enough space on the
       on this application as your         application for all required signatures      Renewing your homestead
       primary residence.                  and Social Security numbers, please          classification
    3. Be a Minnesota resident.            use an extra sheet and include it with       If this property is granted the
                                           the application.                             homestead classification, it is not
Your county assessor will determine if                                                  necessary for you to reapply for the
you are a Minnesota resident for           How we use information                       classification.
homestead purposes. Some of the            The Social Security numbers or
conditions that may be used to             affidavits or other proofs of property       However, at any time, the county
determine your residency status            owners and spouses are private data.         assessor may require you to provide an
include:                                   Minnesota Statutes, section 273.124,         additional application or other proof
                                           subdivision 13, authorizes the               deemed necessary to verify that you
        Are you registered to vote in      collection of Social Security numbers        continue to qualify for the homestead
        Minnesota?                         and signatures of all applicants,            classification.
        Do you have a valid                including spouses, on homestead
        Minnesota driver's license?        applications.                                If you sell, move or change your
        Do you file a Minnesota                                                         marital status
        income tax return?                 The county assessor may share the            If this property is sold, you or your
        Do you list property in            information contained on this form           spouse changes your primary
        Minnesota as your permanent        with the county auditor, county              residence, or you change your marital
        mailing address?                   treasurer, county attorney,                  status, state law requires you to notify
        Do your children, if any,          Commissioner of Revenue, or other            the county assessor within 30 days.
        attend school in Minnesota?        federal, state or local taxing authorities
        Are you a resident of any          to verify your compliance with this          If you fail to notify the county assessor
        other state or country?            and other tax programs. You can              within 30 days of the change, the
                                           refuse to provide the information on         property may be assessed the tax that
Application deadline                       this form.                                   is due on the property based on its
The homestead application must be                                                       correct property class plus a penalty
turned into the county assessor’s office   However, failure to provide this             equal to the same amount.
by December 15 to be eligible for the      information may result in a fractional
homestead classification for taxes         homestead or denial of the homestead         If mailing this application
payable in the following year.             classification equal to the same             Provide all information required for
                                           amount. (Minnesota Statutes, section         your homestead situation. You
Required information                       273.124, subdivision 13, paragraph h)        MUST send a copy of the deed to the
Minnesota Statutes, section 273.124,                                                    property, complete with a legal
subdivision 13 requires Social Security    Penalties                                    description, along with the
numbers and signatures of all owners       Making false statements on this              application to the address listed
                                           application is against the law.              below.


                  Please return this application, along with a copy of the deed to the property, to:
       Anoka County Property Records and Taxation, 2100 3rd Ave., Room 119, Anoka, MN 55303.
J:\FORMS\HOMESTEADnew2006.doc

				
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