APPLICATION FOR SCHOOL TAX HOMESTEAD EXEMPTION
PL-74 (rev. 7/99)
(city or county)
AFFIDAVIT OF CLAIMANT
School Tax Homestead Claimant
(Tax Receiver or Commissioner) or (Authorized City Official)
INCOME FOR YEAR ENDING DECEMBER 31, _______________.
(Subject to Verification)
GROSS INCOME
NAME
SOCIAL SECURITY NO.
(from all sources)