Form 458 - Nebraska Homestead Exemption Application Or Certification Of Status - 2017

Download a blank fillable Form 458 - Nebraska Homestead Exemption Application Or Certification Of Status - 2017 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 458 - Nebraska Homestead Exemption Application Or Certification Of Status - 2017 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

RESET

FORM 458

Nebraska Homestead Exemption Application or Certification of Status

2017

• Nebraska Schedule I – Income Statement must be filed with this form.

• Application for Transfer must be filed by August 15 if moving to a new homestead.

Please Do Not Write In This Space

File with your county assessor after February 1 and by June 30.

Please Type or Print

County

Applicant’s Date of Birth (Mo/Day/Yr)

Applicant’s Social Security Number

Applicant’s Name and Address

Spouse’s Date of Birth (Mo/Day/Yr)

Spouse’s Social Security Number

Legal description of homestead or location and physical description of mobile home:

Filing Status

Single

Married or Closely-related

If you were widowed or divorced since Jan. 1 last year, answer the following:

Spouse’s Name

Date of Death

Date of Final Divorce Decree

Homestead Exemption Categories

• Nebraska Schedule I must be filed for all categories except Numbers 4 and 5.

• See instructions on reverse side for specific requirements.

Qualified owner-occupants age 65 and over.

Veterans totally disabled by a nonservice-connected accident or illness (Annual certification is required — Form 458B or VA certification).

Disabled individuals (see restrictions and instructions for certification requirement).

Veterans drawing compensation from the Department of Veterans Affairs because of 100% service-connected disability, or the unremarried widow(er)

(VA certification required; see instructions for certification requirement).

Paraplegic veteran or multiple amputee whose home value was substantially contributed to by the Department of Veterans Affairs (annual VA certification required).

The unremarried widow(er) of a serviceperson who died while on active duty (VA certification required).

Individuals who have a developmental disability (Form 458B is required).

If category 2 or 6 are checked above, enter veteran’s service dates.

Veteran’s Service Dates Beginning

and Ending

(Month)

(Day)

(Year)

(Month)

(Day)

(Year)

1 Do you currently own this residence?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

2 Do you currently occupy this residence? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

3 If you or your spouse are currently residing in a nursing home, please answer these questions:

• What date did you or your spouse enter the nursing home? _____/_____/_______ (Mo/Day/Yr)

• Have the household furnishings been removed from your residence? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

• Is the residence currently occupied, leased, or rented by another person? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

If Yes, who is residing in the residence?

4 Is this homestead owned by a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

• If Yes, are you residing at this homestead as a beneficiary under the trust instrument? . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

5 If you received a homestead exemption last year, is the preprinted information on this form complete and correct (names,

Social Security numbers, birth dates, filing status, exemption category, other owner-occupants, etc.)? . . . . . . . . . . . . . . . . .

YES

• If No, please indicate the correct information in the appropriate area.

Other Owners Who Occupy The Residence (Attach list if necessary.)

• Nebraska Schedule I — Income Statement must be filed for each owner-occupant (DO NOT repeat applicant and spouse.)

Name

Relationship to Applicant Date of Birth

Social Security Number

(Mo/Day/Yr)

Under penalties of law, I declare that I have examined this form and that it is, to the best of my knowledge and belief, true and correct. I also declare that I am

entitled to the Nebraska homestead exemption and have not applied for a homestead exemption elsewhere in the state.

I am a citizen of the United States.

I am a qualified alien under the Federal Immigration and Nationality Act. My immigration status and alien number are

sign

as follows: ____________________________ and I agree to provide a copy of my USCIS documentation upon request.

here

Signature of Applicant

Date

Telephone Number

FOR COUNTY ASSESSOR’S USE ONLY

Parcel or Location ID Number

Tax District Number