Application For The Residential Relative Homestead Classification
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2Itasca County Homestead Application
Relative Occupied
Application for the Residential Relative Homestead Classification
Please read the back of this form before completing. Each related occupant and owner of the property must sign the application.
The property must be owned and occupied on either January 2 or December 1, and the application must be returned to your
assessor’s office by December 15 to be eligible for homestead classification for taxes payable in the following year. Failure to fully
complete the application may result in a fractional homestead or denial of the homestead classification on the property
described in Section 1.
Making false statements on this application is against the law. Minnesota Statutes, section 609.41 states that anyone giving
false information in order to avoid or reduce their tax obligations is subject to a fine of up to $3,000 and/or up to one year in
This section is to be completed by all applicants. Please provide the following information pertaining to the property on
which homestead is being claimed.
Is this also the mailing address? Yes No
Property address
City
State
Zip
County
Parcel ID or legal description of all property on which homestead is being claimed (if you need more space, please attach a separate sheet of paper):
Date purchased by current owner
Has this property ever been classified as “seasonal residential recreational” since it has
been owned by the current owner or the spouse of the current owner?
Yes
No
/
/
This section is to be completed by all applicants claiming relative homestead. Please provide the following information
pertaining to your previous residence.
Previous address
City
State
Zip
County
Date vacated
Was the property classified as homestead?
Yes
No
/
/
This section is to be completed by applicant(s) claiming relative homestead on the property. Each adult relative
applicant claiming relative homestead and his/her spouse who occupies the property described in Section 1 must fill out the
following information and sign and date the application. If the only occupant who is related to the owner is a minor, then the legal
guardian must fill out the following section and sign on behalf of the minor. By signing below, I certify that the information on this
form is true and correct to the best of my knowledge. I also certify that I am a Minnesota resident, and I occupy the property
described in Section 1 as my primary place of residence.
Social Security number
Date property occupied by applicant
Relative 1
Last name
First name
Middle Initial
/
/
Relationship to owner
Are you listed as an owner on the deed? Yes No
married If married, does your spouse occupy the property? Yes No
What is your marital status?
single
divorced
legally separated
Signature (Relative 1 or legal guardian)
Date
Daytime phone number
X
Relative 2
Last name
First name
Middle Initial
Social Security number
Date property occupied by applicant
/
/
Relationship to owner
Are you listed as an owner on the deed? Yes No
married If married, does your spouse occupy the property? Yes No
What is your marital status?
single
divorced
legally separated
Signature (Relative 2 or legal guardian)
Date
Daytime phone number
X
This section is to be completed by all owners of the property. Please fill out the following information for each owner of the
property described in Section 1 and sign and date the application. By signing below, I certify that the information on this form is
true and correct to the best of my knowledge. I also certify that I own the property described in Section 1, the individuals listed in
Section 2 occupy this property, and the property has never been classified as seasonal residential recreational at any time
during which I or my spouse have owned it.
Owner 1
Last name
First name
Middle Initial
Relationship to applicant claiming relative homestead
Address where you reside
City
State
Zip
Signature (owner 1)
Date
Daytime phone number
X
Owner 2
Last name
First name
Middle Initial
Relationship to applicant claiming relative homestead
Address where you reside
City
State
Zip
Signature (owner 2)
Date
Daytime phone number
X
If you need more space to list additional occupant(s) or owner(s), please provide the information requested
in the corresponding section on a separate sheet of paper and attach it to the application.
Revised 11/05
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