Homestead Exemption Affidavit (Page 2 of 2) in pdf

4. __________

Trust

5. __________

Usufruct

6. __________

Owned in Indivision; Percentage of Ownership _____%

7. __________

Bond for Deed (prior to June 20, 2003)

8. __________

Additional Homestead Exemption for a veteran with a service-connected

disability rating of one hundred (100%) percent by the United States Department of Veterans

Affairs in accordance with the provisions of Louisiana Constitution Article 7 Section 21(K).

IV.

SPECIAL ASSESSMENT EXEMPTION

Appearer hereby claims a special assessment in addition to homestead exemption claimed in

Section III on the property described in Section I in accordance with the provisions of Louisiana

Constitution Article 7 Section 18 and Louisiana law, which said special assessment is extended by

initialing the following appropriate choice(s):

1. __________

Special Assessment Freeze for persons 65 years of age or older

2. __________

Veteran with a service-connected disability rating of fifty (50%) percent by the

United States Department of Veterans Affairs

3. __________

Member of the Armed Forces of the United States or Louisiana National Guard,

who was either killed in action, missing in action, or prisoner of war for a period exceeding

ninety (90) days

4. __________

Person permanently and totally disabled

REQUIRED DOCUMENTATION

Appearer hereby certifies Appearer has attached a copy of the Settlement Statement, Act of Sale

or any document transferring title, Appraisal, and Insurance Declaration Page to assist the assessor in

providing the necessary data to determine the fair market value of the above described property.

VI.

GENERAL PROVISIONS

Appearer hereby certifies he or she is not claiming any other property as his or her homestead for

purposes of this homestead exemption.

Pursuant to La. R.S. 47:2327, this form shall be confidential and solely used by the Ascension

Parish Assessor, the governing authority, and the Louisiana Tax Commission for the purpose of

administering this statute.

SIGNATURE AND VERIFICATION

I declare under the penalties for filing false reports that this Homestead Exemption Affidavit has been

examined by me and to the best of my knowledge and belief is a true, correct, and complete return. If the

return is prepared by someone other than the taxpayer, his declaration is based on all the information

relating to the matters required to be reported in the return of which he has knowledge.

___________________________________

Print Name:

___________________________________

Print Name:

SWORN TO AND SUBSCRIBED before me, Notary, this _____ day of _________________,

20_____.

________________________________________

NOTARY PUBLIC

PRINT NAME:_______________________

NOTARY #:_________________________

Homestead Exemption Affidavit Page 2

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