DTE 105I
Rev. 9/14
Roger Reynolds, CPA, Butler County Auditor
Homestead Exemption Application for Disabled Veterans and Surviving Spouses
File with the county auditor after the first Monday in January and on or before the first Monday in June
FOR COUNTY AUDITOR’S USE ONLY:
First year for Homestead Exemption ______________Parcel Number ___________________________________________________
Auditor’s application number / Taxing District _____________________________________________________________________
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VA Documentation verified
Yes
No
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Granted
Denied
County Auditor/Rep. ______________________________________ Date ___________________
Please read the instructions on the back of this form before you complete it. The applicant must be 100% disabled on Jan. 1 of the
year for which exemption is sought. See Late Application in the instructions on the back of this form.
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Current application
Late application for prior year
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Type of home:
Single family dwelling
Unit in a multi-unit dwelling
Condominium
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Unit in a housing cooperative
Manufactured or mobile home
Land under a manufactured or mobile home
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Applicant’s Name _______________________________________________________________
Surviving Spouse
Yes
No
Name of spouse _________________________________________________________________
Home address _______________________________________________________________________________________________
County __________________________Taxing district/Parcel Number __________________________________________________
(from tax bill or available from county auditor)
In order to be eligible for the enhanced disabled veteran homestead exemption, the form of ownership must be identified. Property
that is owned by a corporation, partnership, LLC or other legal entity does not qualify for the exemption. Check the box that applies to
this property. The applicant is:
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an individual named on the deed
trustee of a trust with the right to live in the property or a
settlor under a revocable or irrevocable inter-vivos trust,
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a purchaser under a land installment contract
holding title to a homestead occupied by the settlor as a right
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a life tenant under a life estate
under the trust
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a mortgagor (borrower) for an outstanding mortgage
a stockholder in a qualified housing cooperative. (See form
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DTE 105A - Supplement for additional information)
other ______________________________________
If the applicant or applicant’s spouse owns any other property (including rentals) please provide the information below:
____________________________________________________________________________________________________________
Address
City, State, ZIP
County
I declare under penalty of perjury that (1) I occupied this property as my principal place of residence on Jan. 1 of the year(s) for which I am
requesting the homestead exemption, (2) I currently occupy this property as my principal place of residence, (3) I did not acquire this homestead
from a relative or in-law, other than my spouse, for the purpose of qualifying for the homestead exemption, (4 )the documentation presented
regarding my disability has been received from the Department of Veterans Affairs, its predecessor or successor agency, and (5) I have
examined this application, and to the best of my knowledge and belief, this application is true, correct and complete.
Signature of applicant _________________________________________________________________________________________
Mailing address ______________________________________________________________________________________________
Date ___________________Phone number _____________________________ E-mail____________________________________
Butler County Auditor’s Office • Third Floor • 130 High St., Hamilton, OH 45011