Application For Homestead Exemption (Form Otc 921)

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OTC
State of Oklahoma
Tax Year
Application for Homestead Exemption
921
2017
________________________________________ County
Return to County Assessor
Revised 7-2016
Name:
______________________________
__________________________
_______
(Last)
(First)
(MI)
Account Number: _______________________________________________________________________
Property Address: ______________________________________________________________________
Mailing Address: _______________________________________________________________________
Daytime Telephone: ( ______ ) ________________ Email Address: _____________________________
School
Legal Description:
District
please mark the appropriate box...
Are you a legal resident of Oklahoma?
Y
N
Is any portion of the property rented or leased?
Y
N
Do you own only a partial or undivided interest?
Y
N
Is the property held in a revocable trust?
Y
N
Y
N
Is your residence a manufactured home?
If a manufactured home, is the title in your name?
Y
N
If a manufactured home, do you own the land where it is located?
Y
N
Is any part of the described property used as commercial?
Y
N
Do you currently, or did you in the previous year, have homestead exemption in this State?
Y
N
If so, list address _________________________ , ______________ City _____________ County
please mark the appropriate box...
Did you own this property on or before January 1 of this year?
Y N
A
Were you occupying this property as your place of residence on January 1 of this year?
Y N
Was or will your deed or other evidence of ownership be of record with the County
Y N
Clerk’s Office on or before February 1 of this year?
NOTE:
(If today’s date is after March 15 of this year, or if you answered “no” to any question in section “A,” you may not qualify
for this year’s exemption. To apply for next year’s exemption, complete section “B” of this application.
Homestead exemption cannot be approved if you do not own and occupy the subject property as your place of
residence on January 1 each year the exemption is applied, including the year of application.
B
please mark the appropriate box...
Do you own this property?
Y N
Will you, to the best of your knowledge, own and occupy this property as your place of
Y N
residence January 1 of next year?
Will your deed or other evidence of ownership be of record with the County Clerk’s Office
Y N
on or before February 1 of next year?
Under penalty of perjury, I the undersigned, affirm that all information provided and herein contained are
true and correct to the best of my knowledge.
Approved beginning ____ tax year.
Disapproved. Reason __________
Applicant’s Signature
Date
_____________________________
_____________________________
_____________________________
County Assessor or Deputy
Date

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