ST. CLAIR COUNTY GENERAL HOMESTEAD APPLICATION ASSESSOR’S OFFICE General Homestead Dept. Please attach a copy of applicant’s driver’s license that 10 Public Square lists address. Along with ID military personnel may provide utility Belleville, Il 62220 current Telephone: (618) 825-2704 bill. If contract for deed or leasehold is in place attach a copy of contract. Facsimile: (618) 825-2757 Complete the following information 1 _________________________________ 2 Enter the assessment year for which you are requesting Applicant’s Name the general homestead exemption ___ ___ ___ ___ Year _________________________________________ 3 Enter the parcel # (PIN) for which you are requesting the exemption. Street address of property Your PIN is on the top right corner of your tax bill. _________________________________________ PIN # _______________________________________________ City, State, and Zip (________)________________________ ________ 4 Is this a single family residence Yes No Daytime Phone 5 Does the applicant receive a homestead exemption anywhere else (in state and out of state)? Yes No If yes, please list address of other location _____________________________________________________________________ 6 Was this a newly constructed home upon your occupancy (Are you the first occupant)? Yes No 7 Date of Occupancy ________________________ 8 Previous Address __________________________________________________________________________________________ Street address City State Zip 9 On Jan 1st were you liable for the payment of real estate taxes on this property? Yes No 10 On Jan 1st were you the owner of record OR did you have an interest in this property through a bond for deed or leasehold contract? Owner Contract for deed Leasehold contract *For Contract for Deed and Leasehold Contracts Only* (Must be renewed annually) 11 If bond for deed or leasehold is checked on #11, please fill out the following: _________________________________ I understand that the real estate taxes may be a Property Owner’s Name(on deed) deductible expense for the occupant of the property. This information may be shared with the Department of Revenue. _________________________________ Authorized Representative’s Printed Name _______ Initials of property owner or authorized representative _________________________________ _________Initials of Occupant Mailing Address I understand that the real estate taxes may NOT be a deductible expense for the property owner. _____________________________________ This information may be shared with the Department of Revenue City, State, and Zip (________)________________________ _______ Initials of property owner or authorized representative Daytime Phone ________ Initials of occupant *Contract for Deedss must be recorded* See back of page to notarize form. GENERAL HOMESTEAD APPLICATION Page of 1 2 5/24/2016 = Page 1 = *Applicant and Property Owner’ may notarize separately* I state to the best of my knowledge, the information on this application is true, correct, and complete. ___________________________________ Applicant’s signature Subscribed and sworn to before me, a Notary Public, on this _________day of _______________________20___ _________________________________________ Notary Public signature *Applicant and Property Owner’ may notarize separately* I state to the best of my knowledge, the information on this application is true, correct, and complete. _______________________________________________ Property owner’s or authorized representative’s signature Subscribed and sworn to before me, a Notary Public, on this _________day of _______________________20___ _________________________________________ Notary Public signature Page of 2 2 5/24/2016 = Page 2 =