30 NE 97 St (8)PROOF OF RESIDENCE FOR ALL OWNERS
OWNER
i Second Owner
Third Owner
Name & Address of each owner not residing on property
Social Security Number required for all residing owners
`-\ '2., �-) 9 ��,�
c -
Date l an
you last became a permanent resident of Florida
y P
?
��`. -)
�1c� .
Date you occupied this property
9 6 .
O
1
Florida Driver's License Number: t , , � ;i0.-,,>.) • , U
& Date of Issue: (per Q tH
& Date of Birth:
1 / -) C- 4 4 / / __
5
Florida Vehicle Tag Number:
& Date of Issue:
1
_ _ _
Are you a U.S. Citizen? YES [ ] NO [ ]
If yes give Florida Voter Number & Registration Date:
If no, Immigration Number (Green Card) & Issue Date:
cr , XV/ e2 .2�j
S OCIAL SECURITY DISCLOSURE '
`
NOTE: Disclosure of your social security number is
mandatory. It is required by section 196.011 (1), Florida `
Statutes. The social security number will be used to verify _
taxpayer identity information, homestead exemption
information submitted to property appraisers, and
intangible fax information.
l) °) / { T' l 9
- F ! J )
Declaration of Domicile (Res. Date & Recorded)
; l (,f,`_ -�'
Current Employer & Work phone number:
F
�� "�'��
Address listed on your last year's IRS Return?
2
OFFICE USE ONLY (WILL SUBMIT):
*NOTE: I hereby authorize this agency to obtain information necessary to determine my eligibility for
the exemption(s) applied for. If all information is not received by MARCH 1ST, your application will be
processed for whatever exemptions you qualify for on that date. I hereby make application for the
exemptions indicated and affirm that I do qualify for same under Florida Statutes. I am a permanent
resident of the State of Florida and I own and occupy the property described above. I understand that
Section 196.131(2) Florida Statutes provides that any person who shall knowingly give false informa-
tion for the purpose of claiming homestead exemption is guilty of a misdemeanor of the first degree,
punishable by a term of imprisonment not exceeding 1 year or a fine not exceeding $5,000 or both.
Further, under penalties of perjury, I declare that I have read the foregoing application and the facts in
it are true.
PROPERTY IDENTIFICATION NUMBER
PROPERTY DESCRIPTION:
MAILING ADDRESS:
NAME: , „
STREET: ,
CITY: _ . .... .
ZIP:
PROPERTY ADDRESS:
„CHECK IF IT WAS A RENTAL PROPERTY: [ ]
COUNTY LAND USE CODE: , PERCENT OF OWNERSHIP: w.k3 %
TYPE OF DEED: DATE OF DEED: DATE RECORDED:
RECORDED: BOOK „ PAGE ,,,
y f .
SIGNATURE OF APPLICANT (S
ATE / & PHONE NUMBER
ORIGINAL APPLICATION FOR TAX EXEMPTION
DADE COUNTY, FLORIDA YEAR
Were you granted property tax exemptions last year?
YES [ ] NO [ ]
Preyious Addre s ,
` r
MARITAL STATUS: SINGLE (4 MARRIED [ ]
SEPARATED [ ] WIDOW [ 1 WIDOWER [ ] DIVORCED [ ]
EXEMPTIONS APPLIED FOR:
* PERMANENT FLORIDA RESIDENCY REQUIRED AS OF JAN. 1
; , ; NEW CHANGE ADDNL.
[ 1
[
[
You mist bring all info rrmr and this completed form, unsigned, in person, to the Property Appraiser's Office bet
$25,000 HOMESTEAD EXEMPTION
$500 WIDOW'S OR WIDOWER'S EXEMPTION
(Must submit Spouse's Death Certificate)
$500 VET. / CIV. DISABILITY EXEMPTION
$500 BLIND PERSON'S EXEMPTION
' EXEMPTION AMOUNTS APPLIED TOWARD ASSESSMENT VALUE
SERVICE CONNECTEP TOTAL &- PERMANENT DISABILITY
EXEMPTION (DOCUMENTATION REQUIRED)
DISABLED VETERANS CONFINED TO WHEELCHAIRS
EXEMPTION (DOCUMENTATION REQUIRED)
CIVILIAN TOTAL & PERMANENT DISABILITY EXEMPTION
(DOCUMENTATION REQUIRED)
een Januay 2, and arch 1, 1996.
HEX: ADDNL:
#RESIDING
OWNERS
DENIAL
DEPUTY'S SIGNATURE & INITIALS
OFFICE USE ONLY
HEX %:
T & P OTHER
P A CLERK INITIALS & DATE
HOMESTEAD EXEMPTION APPLICATION
Our records indicate that during 1995 a deed was filed on this property.
To be assured that You receive all the benefits you are entitled to, please read the following carefully. To be
eligible for a Homestead Exemption, you must be a legal resident of Florida, own and be living in the residence
as of January 1, 1996. YOU WILL LOSE YOUR EXEMPTION IF YOU DO NOT FILE THIS FORM IN PERSON
BY MARCH 1, 1996.
On the reverse side of this form, complete all applicable items.
TWO PROOFS OF FLORIDA RESIDENCE MUST BE PRESENTED TO A DEPUTY AT TIME OF APPLICATION.
SOCIAL SECURITY NUMBER MUST BE SUBMITTED FOR ALL RESIDING OWNERS.
IF YOU OWN A CAR:
Florida Driver's License Number
Florida Automobile License Tag Number
NON - CITIZENS MUST PRESENT AN ALIEN REGISTRATION CARD (GREEN CARD)
IF FILING FOR A TRUST, A COPY OF THE TRUST DOCUMENTS MUST BE SUBMITTED IN FULL.
STEPHEN P. CLARK CENTER
111 N.W. 1st Street Lobby
Monday through Friday
8:30 AM to 4:30 PM
MIAMI BEACH CITY HALL
1700 Convention Center Drive
WEDNESDAY ONLY
8:30 AM TO 4:00 PM
IF YOU DO NOT OWN A CAR: (ANY TWO OF THE FOLLOWING)
Florida Voter Registration Card; Prior Year IRS Return if filed in
Florida; or, W -2 Form; SSA -1099; Florida Intangible Tax Return;
Children School Records; Moving Van Receipt; Doctor, Church, or
Employer letter of recommendation.
SOUTH DADE GOVERNMENT CENTER
10710 SW 211 st Street 2nd Floor
Monday through Friday
8:30 AM to 4:30 PM
HIALEAH BLANCHE MORTON CENTER
300 East 1st Avenue
TUESDAYS & THURSDAYS
8:30 AM TO 4:00 PM
TAMIAMI PARK RECREATION HALL
11201 SW 24th Street NEXT TO POOL
WEDNESDAYS & THURSDAYS
8:30 AM TO 4:00 PM
NORTH MIAMI BEACH
OPTIMIST CLUB
15450 West Dixie Hwy
MONDAYS & FRIDAYS
8:30 AM TO 4:00 PM
THIS APPLICATION MUST BE FILED ON OR BEFORE MARCH 1ST.
To avoid long lines do not wait until the last two weeks to file your application.
Notice: A Tax Lien can be imposed on your property pursuant to section 196.161, Florida Statutes. Section 196.161 (1) provides:
CLOSED FRIDAY,
FEBRUARY 9,
AND MONDAY,
FEBRUARY 12,
1996
Note that not all offices are open on all days. All offices will be closed: Monday, January 15 and February 19.
The North Miami Beach Optimist Club and the South Dade Government Center Office will also be open on Saturday,
February 3rd and 24th, 1996 from 8:00 AM until 12:00 PM.
The information contained in this application will be provided to the Department of Revenue and may also be provided to any
State in which the applicant has previously resided.
(1)(a) "When the estate of any person is being probated or administered in another state under an allegation that such person was a resident
of that state and the estate of such person contains real property situate in this state upon which homestead exemption has been allowed
pursuant to s. 196.031 for any year or years within 10 years immediately prior to the death of the deceased, then within 3 years after the
death of such person the property appraiser of the county where the real property is located shall, upon knowledge of such a fact, record a
notice of tax lien against the property among the public records of that county, and the property shall be subject to the payment of all taxes
exempt thereunder, a penalty of 50 percent of the unpaid taxes for each year, plus 15 percent interest per year, unless the circuit court
having jurisdiction over the ancillary administration in this state determines that the decedent was a permanent resident of this state
during the year or years an exemption was allowed, whereupon the lien shall not be filed or, if filed, shall be canceled of record by the
property appraiser of the county where the real estate is located. (b)In addition, upon determination by the property appraiser that for any
year or years within the prior 10 years a person who was not entitled to a homestead exemption was granted a homestead exemption from
ad valorem taxes, it shall be the duty of the property appraiser making such determination to serve upon the owner a notice of intent to
record in the public records of the county a notice of tax lien. Such property which is situated in this state shall be subject to the taxes
exempted thereby, plus a penalty of 50 percent of the unpaid taxes for each year and 15 percent interest per annum."