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Quick Claim Deed Template - PDF

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                       WASHINGTON COUNTY HOMESTEAD APPLICATION 
  PIN                                                             Taken by                 ASMT Yr                                         City/Twp


                                                           Legal Party                      Modifier                          PTR

                                                     Homestead                 %            Full Year                   Mid-Year
                                                   Notes:




                               PLEASE READ THE BACK OF THIS FORM BEFORE COMPLETING
  Property Address*                 (please print or type) City, State, Zip    Closing Date


  Type of deed (check one) attach copy of deed or decree

         Warranty Deed           Quit Claim Deed            Contract for Deed              Divorce Decree             Other
  1-Owner Name (on deed)                                Do you live here*          Date Moved In   MN Resident         Social Security #
                                                            Yes      No                                 Yes    No

  Marital Status: (check one) **for divorce pending or legal separation you must provide documentation including case#

         Married            Single           Divorced                Divorce Pending**
                                                                            
                                                                                                        Legally Separated**      Widowed
  Previous Address                                      City, State, Zip                           (County - if MN) Date Moved out


  2-Owner Name (on deed)                                Do you live here*          Date Moved In   MN Resident         Social Security #
                                                            Yes      No                                 Yes    No

  Marital Status: (check one) **for divorce pending or legal separation you must provide documentation including case#

         Married            Single           Divorced                Divorce Pending**                  Legally Separated**      Widowed
  Previous Address                                      City, State, Zip                           (County - if MN) Date Moved out


    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 form is complete, true, and correct.
  Signature (s)                                      Home Phone #          Cell Phone #         Work Phone #            Today’s Date




  You must complete this section if: You are the spouse of the owner but not listed on the deed OR you do not occupy above property*
  Name                                                 Reason for living apart            MN Resident            Social Security #
                                                                                                    Yes        No
  Current Address                                       City, State, Zip                           (County - if MN)    Date Moved In


  Previous Address                                      City, State, Zip                                               Date Moved Out


  Signature                                                                        Phone                               Today’s Date


                                                                                                                                       REV 11/09
       Applying for the owner occupied homestead classification

How to apply                              Required information                       Penalties
To apply for the homestead                Minnesota Statutes, section 273.124,       Making false statements on this
classification for your residence, you    subdivision 13 requires Social             application is against the law.
must fill out this application. To        Security numbers and signatures of all     Minnesota Statutes, section 609.41
qualify for the homestead                 owners occupying the property and          states that anyone giving false
classification, you must:                 each owner’s spouse that occupies          information in order to avoid or
(All three must apply.)                   the property to be listed on this          reduce their tax obligations is subject
                                          application. Additionally, each            to a fine of up to $3,000 and/or up to
                                          owner’s spouse who occupies the            one year in prison.
  1.   Be one of the owners of the
                                          property also must be listed on the
       property listed on this
                                          homestead application even if the          In addition, the property owner may
       application.
                                          owner’s spouse is not listed as an         be required to pay all tax which is due
  2.   Occupy the property listed on      owner on the deed of record. If there is   on the property based on its correct
       this application as your primary   not enough space on the application        property class, plus a penalty equal to
       residence.                         for all required signatures and Social     the same amount. (Minnesota Statutes,
                                          Security numbers, please complete as       section 273.124, subdivision 13,
  3.   Be a Minnesota resident.
                                          many homestead applications as             paragraph)
                                          necessary.
Your county assessor will determine if
                                                                                     Renewing your homestead
you are a Minnesota resident for
                                          How we use information                     classification
homestead purposes. Some of the
                                          The Social Security numbers or             If this property is granted the
conditions that may be used to
                                          affidavits or other proofs of property     homestead classification, it is not
determine your residency status
                                          owners and spouses are private data.       necessary for you to reapply for the
include:
                                          Minnesota Statutes, section 273.124,       classification.
                                          subdivision 13, authorizes the
  •    Are you registered to vote in      collection of Social Security numbers      However, at any time, the county
       Minnesota?                         and signatures of all applicants,          assessor may require you to provide
                                          including spouses, on homestead            an additional application or other
  •    Do you have a valid Minnesota      applications.                              proof deemed necessary to verify that
       driver's license?                                                             you continue to qualify for the
  •    Do you file a Minnesota            The county assessor may share the          homestead classification.
       income tax return?                 information contained on this form
                                          with the county auditor, county            If you sell, move or change your
  •    Do you list property in            treasurer, county attorney,                marital status
       Minnesota as your permanent        Commissioner of Revenue, or other          If this property is sold, you or your
       mailing address?                   federal, state or local taxing             spouse changes your primary
                                          authorities to verify your compliance      residence, or you change your marital
  •    Do your children, if any, attend
                                          with this and other tax programs.          status, state law requires you to notify
       school in Minnesota?
                                                                                     the county assessor within 30 days.
  •    Are you a resident of any other    You can refuse to provide the
       state or country?                  information on this form. However,         If you fail to notify the county
                                          failure to provide this information may    assessor within 30 days of the change,
                                          result in a fractional homestead or        the property may be assessed the tax
Application deadline                      denial of the homestead classification.    that 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                                                    equal to the same amount.
office by December 15 to be eligible
for the homestead classification for                                                  
taxes payable in the following year.
                                          Please return this application to: 
                                           
                                          Washington County Property Records & Taxpayer Services 
                                          Attn:  Assessment Tech Support ‐ Homestead     
                                          14949 62nd St N         
                                          PO Box 6 
                                          Stillwater, MN 55082 

								
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