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Over 65 Exemption Claim Affidavit

Over 65 Exemption Claim Affidavit

Revenue Commission

Blount County, Alabama

220 Second Avenue East, Room 102
Oneonta, Alabama 35121

TEL: (205) 625-4117
www.blountrevenue.com
property@blountcountyal.gov

Gregg Armstrong
Revenue Commissioner

Wendy Green
Chief Clerk

Over 65 Exemption Claim Affidavit

This exemption is based on age. The information given below is to determine the amount of exemption for the following tax year.

PROPERTY OWNER/APPLICANT INFORMATION

(owner’s name(s) must match names on deed)
Owner #1 (Required)

LAST NAME:(Required)

FIRST NAME:(Required)

Phone:(Required)

Email:(Required)

Date of Birth:(Required)

MM slash DD slash YYYY

Owner #2 (Optional)

LAST NAME:

FIRST NAME:

Phone:

Email:

Date of Birth:

MM slash DD slash YYYY

Relationship to Owner #1:

You MUST have the deed for this property recorded in the Blount County Judge of Probate office prior to claiming this Over 65 Exemption.

Recorded Deed Book(Required)

Page(Required)

(If unknown, go to www.blountcountyalprobate.com to search recorded deeds.)

PROPERTY INFORMATION

Is this home your primary residence?(Required)

Yes

No (If no, please explain below)

Is this a Manufactured Home?

Type here(Required)

Untitled(Required)

Existing Manufactured Home or

New Manufactured Home (If so, a title application and bill of sale are required.)

File(Required)

Max. file size: 2 GB.

File(Required)

Max. file size: 2 GB.

Physical Address:(Required)

Street Address City State ZIP Code

Mailing Address for Property Tax Notice same as physical address?(Required)

Yes

No (If no, please complete below)

Mailing Address:(Required)

Street Address City State ZIP Code

***Please note why different mailing address below…

Do you own any other homes?

Do you own any other homes?

If so, list below complete addresses of each home, and if you claim homestead , use it as a second home, or a rental.(Required)

Any other homestead must be cancelled before this claim can be processed.

Did you and/or your spouse file a Federal Income Tax Return this year?(Required)

No

Yes

If yes, is the Taxable Income line as shown on the Federal Income Tax Return – Form 1040 (line 15)(Required)

MORE than $12,000 or

LESS than $12,000 (Must upload a copy of the Federal Income Tax Return for proof)

Did you and/or your spouse file an Alabama Income Tax Return this year?(Required)

No

Yes

If yes, is the Adjusted Gross Income as shown on the Alabama Income tax return – Form 40 (line 10) or Form 40A (line 7)(Required)

MORE than $12,000 or

LESS than $12,000 (Must upload a copy of Alabama Income Tax Return proof)

This application MUST include at least two supporting documents for proof of residence, such as utilities bill, homeowner’s insurance policy, etc., stating this is your primary residence, AND a document showing date of birth, such as drivers license or birth certificate. These documents MUST show the name of the applicants.

File(Required)

Drop files here or

Max. file size: 2 MB.

File(Required)

Drop files here or

Max. file size: 2 MB.

I hereby affirm that this statement is true and correct to the best of my knowledge and that any fraudulent statement is subject to a penalty of perjury.

Signature(Required)

(Over 65 years of age Homeowner)

Date(Required)

MM slash DD slash YYYY

Printed Name:(Required)

Blount County Revenue Commissioner
Gregg Armstrong

Blount County Courthouse

220 2nd Ave E
Oneonta, AL 35121
205-625-6868
Monday - Friday
8:00am - 5:00pm

Hayden Satellite Office

306 2nd Ave,
Hayden, AL 35079
205-590-2851
Monday - Friday
8:00 am - 5:00 pm
*Closed for lunch each day
12:00pm - 1:00pm

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BLOUNT COUNTY COURTHOUSE

220 2nd Ave E
Oneonta, AL 35121
205-625-6868
Monday - Friday
8:00am - 5:00pm

HAYDEN SATELLITE OFFICE

306 2nd Ave,
Hayden, AL 35079
205-590-2851
Monday - Friday
8:00 am - 5:00 pm
*Closed for lunch each day
12:00pm - 1:00pm

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