Form 50-764 - Application For Residence Homestead Exemption For Disabled Veteran With 100 Percent Disability - 2009

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Susan Combs Texas Comptroller of Public Accounts
Texas Property Tax
Application for Residence Homestead Exemption
Form 50-764
for Disabled Veteran with 100 Percent Disability
2009
T E M POR A RY
______________________________________________________________________________________________________________________________
_____________________________________________________
Appraisal District Name
Phone (Area Code and Number)
_________________________________________________________________________________________________________________________________________________________________________________________
Address
This temporary form applies to your residence homestead exemption as of January 1, 2009. Be sure to attach documen-
tation. If the chief appraiser grants the exemption, you do not need to reapply annually, but you must reapply if the chief
appraiser requires you to do so. You must notify the chief appraiser in writing if and when your right to this exemption
ends or your disability rating changes. Return the completed form to your appraisal district.
STEP 1: NAME AND ADDRESS OF OWNER
Name of Owner
Phone (Area Code and Number)
Present Mailing Address (Number and Street)
City, Town or Post Office, State, ZIP Code
Driver’s License, Personal I.D. Certificate or Social Security Number*:
STEP 2: DESCRIBE YOUR PROPERTY
Street Address (if different from above, or legal description if no street address; include property account number, if available)
Number of Acres (not to exceed 20) used for residential occupancy of the structure, if the land and structure have identical ownership
__________________________
acres
Mobile Home:
Make
Model
Identification Number
Attach a copy of statement of ownership and location issued by the Texas Department of Housing and Community Affairs if home is 8’ x 40’ or larger, or attach a verified copy of the purchase con-
tract that shows you are the owner of the mobile home unless your title information appears on the Texas Department of Housing and Community Affairs’ Web site. If so, the appraisal district may
us the Web site documents to verify your eligibility.
STEP 3: DISABLED VETERAN INFORMATION
You qualify for this exemption if you are a disabled veteran who receives from the United States Department of Veterans Affairs or its successor 100 percent disability compensation due to a
service-connected disability and a rating of 100 percent disability or of individual unemployment.
Branch of Service
Disability Rating
Age
Serial Number
Attach a copy of your award letter, “VA tax letter” or other document from the United States Department of Veterans Affairs showing 100 percent disability compensation due to a service-connected
disability and a rating of 100 percent disabled or of individual unemployability.
STEP 4: SIGN THE APPLICATION
I certify the information on this document and any attachment is true and correct to the best of my knowledge.
__________________________________________________________________________________________________________________
_____________________________________________________________
Authorized Signature
Date
If you make a false statement on this form, you could be found guilty of a Class A misdemeanor or a state jail felony
under Texas Penal Code Section 37.10
*You are required to give us this information on this form, in order to perform tax related functions for this office. Tax Code, Section 11.43 authorizes this office to request this information to determine
tax compliance. The chief appraiser is required to keep the information confidential and not open to public inspection, except to appraisal office employees who appraise property and as authorized
by Tax Code, Section 11.48(b).
For more information, visit our Web site:
Form 50-764 • 6-09/1

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