ED | = 32.29.22.41.0053 For Office use only
= 697 SURREY AVE oo
soos: ST PAUL MN 55106-5521 1
IDF.
Application for Homestead Classification
Please read the back of this form before completing, You must own and occupy the property on ether January 2 or December 1,
and the appicaton must be returned to your assessor's ofice by December 15 to be elighble for homestead classification for taxes
payable in the folowing yoar. Failure to fully eomplote the application may recut in a fractional homestead or denial of the
homestead classification on the property described in Section 1.
Making ‘ments on this application is againat the law. Minnasata Statutes, section 609.41 states that anyone aivina
false information in order to avoid or reduce their tax obligations is subject toa fine of up to $3,000 andlor up to one year in prison.
‘Thie eection ie to be completed by all applicante. Ploase provide the following information pertaining to the property yous own
‘and on which you are claiming homestead.
Property acess Is his also your mailing address? C1Yes CINo
ow Sais a County
ParoaiD =a
‘Seaton 1 ~ Property Information
this property adjacent to another property you own thats curently receiving homestead? [] Yes [}No
~This eoction ie to be complted by all applicants. Please provide the folowing information pertaining fo your previo resihence.
i Proves adass
« | Cy | State |ze County
j co ! Was the property classified as homestead? []Yes [No
This section is to be completed by applicant(s) claiming homestead on the property. Each applicant must print hisher
‘name and Social Security number below, answer the questions, sign, and date the application. By signing below, I certly that the
the property described in Section 1 as my primary place of residence.
Occupant Lastname Fistname Midd nial Seal Soar ramber
Are you listed as an owner on the deed? C1 Yes CINoDateOwned___/ _/ __YourMovelnDate__/ _/
information on this form is true and correct fo the best of my knowledge. | also certly that | am a Minnesota resident, and | cacupy
‘Whatis yourmartal status? single Limanied_ifmarried, does your spouse occupy the property? 0 Yes CIN
Llwidowed Claivorced Dilegaly separated
‘Signatine (Oneapant 1) ‘Date ] Davee phone number
Xx _ |
OesapanLaae Fae Teal bear nar
‘Are you listed as an owner on the deed? CI Yes C1No Date Owned 77 Your Move In Date. ae
‘Whats your marital status? Lsingle. LImaried_if married, does your spouse occupy the property? I Yes. T1No
Dwidowed Lidivorced Dilegally separated
Sipe Coane) ale Davie phone rarer
Xx
Please answer the questions below.
Are all owners who are listed on the deed claiming homestead? 1 Yes O No
Ine, ploase contact 851 266 2000 or PropertyTaxino@ c0.amsey ran. Us
Does a relative occupy this property? Cl Yes C1 No-
‘Ave there more than two ownerioxcupants? DYes ONe
tyes, additional forrss must be completed. Contact 651-266-2000 or Property Taxinfo@co.ramsey.mn.us
‘Section3-Appleants) claiming homestead on proserty
Section 4 Additonal
Information
Revised 112007Applying for the owner occupied homestead classification
How to apply
To apply for the homestead
classification for your residence, you
‘must fill out this application. To
qualify for the homestead
classification, you must: (All three
‘ust apply.)
1. Be one of the owness of the
property listed on this
application,
2. Occupy the propety listed on
this application as your primary
residence.
3. Bea Minnesota resident.
Your county assessor will determine
if you are a Minnesota resident for
homestead purposes. Some of the
conditions that may be used to