MEMORANDUM Amanda Carey, Deputy Cabinet …floridarevenue.com/rules/pdf/pto_2017_adoption_120617.pdf · Memorandum December 13, 2017 Page 2 What do the proposed rules do? Rule 12D-7.001,

Child Support – Ann Coffin, Director General Tax Administration – Maria Johnson, Director Property Tax Oversight– Dr. Maurice Gogarty, Director Information Services – Damu Kuttikrishnan, Director

www.floridarevenue.com Florida Department of Revenue Tallahassee, Florida 32399-0100

Executive Director Leon M. Biegalski

December 13, 2017 MEMORANDUM TO: The Honorable Rick Scott, Governor Attention: Kristin Olson, Deputy Chief of Staff Amanda Carey, Deputy Cabinet Affairs Director The Honorable Jimmy Patronis, Chief Financial Officer Attention: Robert Tornillo, Director of Cabinet Affairs Stephanie Leeds, Deputy Director of Cabinet Affairs The Honorable Pam Bondi, Attorney General Attention: Andrew Fay, Director of Legislative and Cabinet Affairs Erin Sumpter, Deputy Director of Cabinet Affairs The Honorable Adam Putnam, Commissioner of Agriculture and Consumer Services Attention: Brooke McKnight, Director of Cabinet Affairs Jessica Field, Deputy Cabinet Affairs Director THRU: Leon Biegalski, Executive Director FROM: Debbie Longman, Director, Legislative and Cabinet Services SUBJECT: Requesting Adoption and Approval to File and Certify Proposed Rules Statement of Sections 120.54(3)(b) and 120.541, F.S., Impact: No impact The Department has reviewed these proposed amended rules for compliance with sections 120.54(3)(b) and 120.541, F.S. These proposed rules will not have an adverse impact on small businesses, small counties, or small cities, and they are not likely to have an increased regulatory cost in excess of $200,000 within one year. Additionally, the proposed rules are not likely to have an adverse impact or increased regulatory costs in excess of $1,000,000 within five years. What is the Department requesting? The Department requests final adoption of the proposed rules below, and approval to file and certify them with the Secretary of State under Chapter 120, F.S.

Memorandum December 13, 2017 Page 2

What do the proposed rules do? Rule 12D-7.001, F.A.C., Applications for Exemptions The proposed changes amend Rule 12D-7.001, F.A.C., to:

Add two statutes to the list in subsection (4) to parallel s. 196.011(1)(b), which requires applicants to include the social security numbers on the exemption application form, DR-501.

Add the title of Form DR-501 for identification purposes. Rule 12D-16.002, F.A.C., Index to Forms The proposed changes to Rule 12D-16.002, F.A.C.:

Amend Form DR-403EB, The 20XX Ad Valorem Assessment Rolls Exemption Breakdown of ____County, Florida, to add new exemptions for the property appraiser to identify the number and value of exemptions for the tax roll certification. These additions are based on section 2 of Chapter 2017-105, L.O.F., which created s. 196.102, F.S., for totally and permanently disabled first responders and section 3 of Chapter 2017-118, L.O.F., which created s. 196.182, F.S., allowing an exemption of 80 percent of the assessed value of a renewable energy source device for tangible personal property (TPP) equipment.

Amend Form DR-403V, The 20XX Revised Recapitulation of the Ad Valorem Assessment Roll,

Value Data, to incorporate new exemption types and correct line references for value calculations. These additions are based on section 2 of Chapter 2017-105, L.O.F., which created s. 196.102, F.S., for totally and permanently disabled first responders and section 3 of Chapter 2017-118, L.O.F., which created s. 196.182, F.S., allowing an exemption of 80 percent of the assessed value of a renewable energy source device for TPP equipment.

Amend Form DR-405, Tangible Personal Property Tax Return, to add line 24 to include renewable

energy source devices, update the schedules on page 2 of the form to include new line 24, and add instructions for line 24 on page 3. The legislature enacted these changes in section 3 of Chapter 2017-118, L.O.F., which created s. 196.182, F.S. The amendments also expand the definition of “inventory,” which the legislature enacted in section 2 of Chapter 2017-36, L.O.F., amending s. 192.011(11)(c), F.S.

Amend Form DR-489EB, The 20XX Ad Valorem Assessment Rolls Exemption Breakdown of ____ County, Florida, to add new exemptions to the current list of exemptions. The additions are based on the same statutory amendments for Form DR-403EB above.

Amend Form DR-489V, The 20XX Preliminary Recapitulation of the Ad Valorem Assessment Roll, Value Data, to add to the listed exemptions. The additions are based on the same statutory amendments for Form DR-403V above.

Amend Form DR-501, Original Application for Homestead and Related Tax Exemptions, to incorporate exemptions the legislature enacted in section 2 of Chapter 2017-105, L.O.F., which

Memorandum December 13, 2017 Page 3

created s. 196.102, F.S. This promulgation activity incorporates changes adopted by Emergency Rule 12DER17-02. The proposed amendment changes the certification statement for the applicant and co-applicant’s signature.

Amend Form DR-504, Ad Valorem Tax Exemption Application and Return, to incorporate

changes the legislature enacted in Chapter 2017-36, L.O.F., and other statutory changes as needed. Section 3 of the chapter amended s. 196.012, F.S., adding part 1 of Chapter 429, F.S., to the definition of “nursing home.” Section 6 of the chapter amended s. 196.1978, F.S., adding a discount for multi-family housing projects that meet certain requirements. Changes include adding affordable housing as an option to apply for an exemption, adding a list of questions and check boxes for affordable housing for multi-family property requirements, and formatting the form to accommodate the new exemption.

Were comments received from external parties? Yes, The Department held a workshop on September 20, 2017 and several interested parties attended through a teleconference system. One individual suggested clarification on language to Form DR-504, referencing when to file the annual application and return. The Department reviewed the suggestion and determined the form did not require additional changes. The Department published Notices of Proposed Rule on October 19, 2017, and provided that, if requested in writing, the Department would hold a rule hearing on November 9, 2017. A hearing was not requested. The Department received a comment of technical nature from the staff of the Joint Administrative Procedures Committee (JAPC) of the Florida Legislature. In response, the Department removed a duplicate word. The proposed rule text presented today incorporates the requested change to Rule 12D-16.002(6)(b), F.A.C. Attachments

Summaries of the proposed rules, which include: o Statements of facts and circumstances justifying the rules o Federal comparison statements o Summary of workshop and hearing

Rule text Incorporated materials

1

STATE OF FLORIDA

DEPARTMENT OF REVENUE

PROPERTY TAX OVERSIGHT PROGRAM

CHAPTER 12D-7, FLORIDA ADMINISTRATIVE CODE

EXEMPTIONS

PROPOSED AMENDMENTS TO RULE 12D-7.001, F.A.C.

SUMMARY OF PROPOSED RULE

The proposed amendments to Rule 12D-7.001, F.A.C., incorporate changes the Florida

Legislature enacted in Chapter 2017-105, L.O.F. The proposed amendments include adding two

statute references to parallel s. 196.011(1)(b), F.S., which requires applicants to include their

social security numbers on the exemption application form, DR-501, when filing for homestead

exemption. The Department of Revenue is adding the title of Form DR-501 for identification

purposes. Section 194.011, F.S., is added to the history notes to include the statute reference for

subsection (4) of the rule.

FACTS AND CIRCUMSTANCES JUSTIFYING PROPOSED RULE

The purpose of the proposed amendments to this rule is to incorporate changes the Florida

Legislature enacted in section 1 of Chapter 2017-105, Laws of Florida, which amended s.

196.011, F.S.

2

FEDERAL COMPARISON STATEMENT

The provisions contained in this proposed amended rule chapter do not conflict with

comparable federal laws, policies, or standards.

SUMMARY OF RULE DEVELOPMENT WORKSHOP HELD SEPTEMBER 20, 2017

The Department of Revenue published a Notice of Rule Development for proposed

amendments to Rule 12D-7.001, F.A.C., in the Florida Administrative Register on September 6,

2017 (Vol. 43, No. 173, p. 3855). The Department held a rule development workshop on

September 20, 2017, and invited interested parties and county officials to attend in person and

through a teleconference system. No one presented comments at the workshop, and the

Department received no written comments.

SUMMARY OF PUBLIC HEARING HELD OCTOBER 17, 2017

The Governor and Cabinet, sitting as head of the Department of Revenue, met on October 17,

2017, and approved the publication of the Notice of Proposed Rule for 12D-7.001, F.A.C. A notice

for the public meeting was published in the Florida Administrative Register on October 10, 2017

(Vol. 43, No. 196, p. 4372).

SUMMARY OF RULE HEARING NOVEMBER 9, 2017

A Notice of Proposed Rule was published in the Florida Administrative Register on October

19, 2017 (Vol 43, No. 203, pp. 4565-4566), to advise the public of the proposed changes to Rule

12D-7.001, F.A.C., and to provide that, if requested in writing, a rule hearing would be held on

3

November 9, 2017. No requests for a rule hearing were received, and no rule hearing was held.

No comments were received by the Department.

1

STATE OF FLORIDA




EXEMPTIONS

AMENDING RULE 12D-7.001

12D-7.001 Applications for Exemptions.

(1) through (3) No change.

(4) Each new applicant for an exemption under Sections 196.031, 196.081, 196.091, 196.101,

196.102, 196.173, or 196.202, F.S., must provide his or her social security number and the social

security number of his or her spouse, if any, in the applicable spaces provided on the application

form, Form DR-501, Original Application for Homestead and Related Tax Exemptions

(incorporated by reference in Rule 12D-16.002, F.A.C.). Failure to provide such numbers will

render the application incomplete. If an applicant omits the required social security numbers and

files an otherwise complete application, the property appraiser shall contact that applicant and

afford the applicant the opportunity to file a complete application on or before April 1. Failure to

file a completed application on or before April 1 shall constitute a waiver of the exemption for

that tax year, unless the applicant can demonstrate that failure to timely file a completed

application was the result of a postal error or, upon filing a timely petition to the value

adjustment board, that the failure was due to extenuating circumstances as provided in Section

196.011, F.S.

(5) No change.

2

Rulemaking Authority 195.027(1), 213.06(1) FS. Law Implemented 192.047, 194.011, 196.011

FS. History–New 10-12-76, Amended 11-10-77, Formerly 12D-7.01, Amended 11-21-91, 12-27-

94, 12-31-98, xx-xx-xx.

1

STATE OF FLORIDA




ADMINISTRATION OF FORMS

PROPOSED AMENDMENTS TO RULE 12D-16.002, F.A.C.

SUMMARY OF PROPOSED RULE

The proposed amendments to Rule 12D-16.002, F.A.C., implement statutory changes enacted

in the 2017 legislative session and update forms for statutory compliance. Amended forms

include:

Form DR-403EB, The (tax year) Ad Valorem Assessment Rolls Exemption Breakdown

of ____ County, Florida

Form DR-403V, The (tax year) Revised Recapitulation of the Ad Valorem Assessment

Roll, Value Data

Form DR-405, Tangible Personal Property Tax Return

Form DR-489EB, The (tax year) Ad Valorem Assessment Rolls Exemption Breakdown

of ____ County, Florida

Form DR-489V, The (tax year) Preliminary Recapitulation of the Ad Valorem

Assessment Roll, Value Data

Form DR-501, Original Application for Homestead and Related Tax Exemptions

Form DR-504, Ad Valorem Tax Exemption Application and Return

2

FACTS AND CIRCUMSTANCES JUSTIFYING PROPOSED RULE

The purpose of amending Rule 12D-16.002, F.A.C., is to implement statutory changes

enacted in the 2017 legislative session and to update seven forms for statutory compliance. The

amendments to the forms incorporated in this rule reflect the statutory changes in Sections 2, 3,

and 6 of Chapter 2017-36; Section 2 of Chapter 2017-105; and Section 3 of Chapter 2017-118,

Laws of Florida.

FEDERAL COMPARISON STATEMENT

The provisions contained in this proposed amended rule chapter do not conflict with

comparable federal laws, policies, or standards.

SUMMARY OF RULE DEVELOPMENT WORKSHOP HELD SEPTEMBER 20, 2017

The Department of Revenue published a Notice of Rule Development for proposed

amendments to Rule 12D-16.002, F.A.C., in the Florida Administrative Register on September 6,

2017 (Vol. 43, No. 173, pages 3855-3856). The Department held a rule development workshop

on September 20, 2017, and invited interested parties and county officials to attend in person and

through a teleconference system. At the workshop, one individual presented a comment on Form

DR-504, and the Department received no written comments. The Department reviewed the

comment and determined the form did not require further changes.

SUMMARY OF PUBLIC HEARING HELD OCTOBER 17, 2017

The Governor and Cabinet, sitting as head of the Department of Revenue, met on October

17, 2017, and approved the publication of the Notice of Proposed Rule for 12D-16.002, F.A.C. A

3

notice for the public meeting was published in the Florida Administrative Register on October

10, 2017 (Vol. 43, No. 196, p. 4372).

SUMMARY OF RULE HEARING NOVEMBER 9, 2017

The Department of Revenue published a Notice of Proposed Rule in the Florida

Administrative Register on October 19, 2017 (Vol. 43, No. 203, pp. 4566-4568), to advise the

public of the proposed changes to Rule 12D-16.002, F.A.C., and to provide that, if requested in

writing, the Department would hold a rule hearing on November 9, 2017. The Department

received no requests and, therefore, did not hold a rule hearing. The Department also did not

receive any public comments.

The Department received a comment of technical nature from the staff of the Joint

Administrative Procedures Committee (JAPC) of the Florida Legislature. In response, the

Department removed a duplicate word. The final rule language presented for adoption today

reflects this change.

1

STATE OF FLORIDA




ADMINISTRATION OF FORMS

AMENDING RULE 12D-16.002

12D-16.002 Index to Forms. (1) The following paragraphs list the forms adopted by the Department of Revenue. A copy

of these forms may be obtained from the Department’s website at

http://floridarevenue.com/property/, or by writing to: Property Tax Oversight Program,

Department of Revenue, Post Office Box 3000, Tallahassee, Florida 32315-3000. The

Department of Revenue adopts, and incorporates by reference in this rule, the following forms

and instructions:

Form Number Form Title Effective Date

(2) through (5)(a) No change.

(5)(b) DR-403EB The 20XX (tax year) Ad Valorem Assessment Rolls Exemption

Breakdown of _____County, Florida (r. xx/xx 6/11)

https://www.flrules.org/Gateway/reference.asp?No=Ref-01737 xx/xx 11/12

https://www.flrules.org/Gateway/reference.asp?No=Ref-

(6)(a) DR-403PC No change.

(b) DR-403V The 20XX (tax year) Revised Recapitulation of the Ad Valorem

Assessment Roll, Value Data (n. 6/11 r. xx/xx)

2

https://www.flrules.org/Gateway/reference.asp?No=Ref-01739


xx/xx 11/12

(7)(a) through (7)(b) No change.

(7)(c) DR-405 Tangible Personal Property Tax Return (r. xx/xx 12/11)



xx/xx 11/12

(7)(d) through (28) No change.

(29)(a) DR-489EB The 20XX (tax year) Ad Valorem Assessment Rolls Exemption

Breakdown of ____ County, Florida (r. xx/xx 6/11)


xx/xx 11/12

https://www.flrules.org/Gateway/reference.asp?No=Ref- (b) DR-489PC No change.

(c) DR-489V The 20XX (tax year) Preliminary Recapitulation of the Ad Valorem

Assessment Roll, Value Data (r. xx/xx n. 6/11)


xx/xx 11/12


(30) through (38) No change.

(39)(a) DR-501 Original Application for Homestead and Related Tax Exemptions

(r. xx/xx 11/12)


xx/xx 11/12


(b) through (40) No change.

(41)(a) DR-504 Ad Valorem Tax Exemption Application and Return (r. xx/xx 11/01) xx/xx 12/01

3


(b) through (61) No change.

Rulemaking Authority 195.027(1), 213.06(1) FS. Law Implemented 92.525, 95.18, 136.03,

192.001(18), 192.0105, 193.052, 193.077, 193.085, 193.092, 193.114, 193.122, 193.155,

193.1554, 193.1555, 193.1556, 193.461, 193.501, 193.503, 193.625, 193.703, 194.011, 194.032,

194.034, 194.035, 194.037, 195.002, 195.022, 195.087, 196.011, 196.015, 196.031, 196.075,

196.095, 196.101, 196.102, 196.121, 196.141, 196.151, 196.173, 196.183, 196.193, 196.1961,

196.1983, 196.1995, 196.202, 196.24, 196.26, 197.182, 197.222, 197.2423, 197.2425, 197.3632,

197.3635, 197.414, 197.432, 197.472, 197.502, 197.512, 197.552, 200.065, 200.069, 213.05,

218.12, 218.125, 218.66, 218.67 FS. History–New 10-12-76, Amended 4-11-80, 9-17-80, 5-17-

81, 1-18-82, 4-29-82, Formerly 12D-16.02, Amended 12-26-88, 1-9-92, 12-10-92, 1-11-94, 12-

27-94, 12-28-95, 12-25-96, 12-30-97, 12-31-98, 2-3-00, 1-9-01, 12-27-01, 1-20-03, 1-26-04, 12-

30-04, 1-16-06, 10-2-07, 3-30-10, 11-1-12, 9-10-15, 4-5-16, 6-14-16, 1-9-17, 9-19-17, .

Property Roll

AffectedType of Exemption

Number of

ExemptionsValue of Exemption

Number of


1 § 196.031(1)(a) Real $25,000 Homestead Exemption 1

2 § 196.031(1)(b) Real Additional $25,000 Homestead Exemption 2

3 § 196.075 Real Additional Homestead Exemption Age 65 and Older 3

4 § 196.081 Real Totally & Permanently Disabled Veterans & Surviving Spouse 4

5 § 196.091 Real Totally Disabled Veterans Confined to Wheelchairs 5

6 § 196.095 Real Licensed Child Care Facility in Enterprise Zone 6

7 § 196.101 RealQuadriplegic, Paraplegic, Hemiplegic & Totally & Permanently Disabled &

Blind (Meeting Income Test)7

8 § 196.183 Personal $25,000 Tangible Personal Property Exemption 8

9 § 196.196 Real & Personal Constitutional Charitable, Religious, Scientific or Literary 9

10 § 196.1961 Real Historic Property for Commercial or Nonprofit Purposes 10

11 § 196.197 Real & Personal Charitable Hospitals, Nursing Homes & Homes for Special Services 11

12 § 196.1975 Real & Personal Charitable Homes for the Aged 12

13 § 196.1977 Real Proprietary Continuing Care Facilities 13

14 § 196.1978 Real & Personal Affordable Housing Property 14

15 § 196.198 Real & Personal Educational Property 15

16 § 196.1983 Real & Personal Charter School 16

17 § 196.1985 Real Labor Union Education Property 17

18 § 196.1986 Real Community Center 18

19 § 196.1987 Real & Personal Biblical History Display Property 19

20 § 196.199(1)(a) Real & Personal Federal Government Property 20

21 § 196.199(1)(b) Real & Personal State Government Property 21

22 § 196.199(1)(c) Real & Personal Local Government Property 22

23 § 196.199(2) Real & Personal Leasehold Interests in Government Property 23

24 § 196.1993 Real Agreements with Local Governments for use of Public Property 24

25 § 196.1995 Real & Personal Parcels Granted Economic Development Exemption 25

26 § 196.1997 Real Historic Property Improvements 26

27 § 196.1998 Real Historic Property Open to the Public 27

28 § 196.1999 Personal Space Laboratories & Carriers 28

29 § 196.2001 Real & Personal Non-for-Profit Sewer & Water Company 29

30 § 196.2002 Real & Personal Non-for-Profit Water & Waste Water Systems Corporation 30

31 § 196.202 Real & Personal Blind Exemption 31

32 § 196.202 Real & Personal Total & Permanent Disability Exemption 32

33 § 196.202 Real & Personal Widow's Exemption 33

34 § 196.202 Real & Personal Widower's Exemption 34

35 § 196.24 Real & Personal Disabled Ex-Service Member Exemption 35

36 § 196.26(2) Real Land Dedicated in Perpetuity for Conservation Purposes (100%) 36


38 § 196.173 Real Deployed Service Member's Homestead Exemption 38

39 § 196.075 Real Additional Homestead Exemption Age 65 and Older and 25 yr Residence 39

40 § 196.102 Real Totally & Permanently Disabled First Responders & Surviving Spouse 40

41 § 196.182 Personal Renewable Energy Source Devices (80% exemption) 41

Note: Centrally assessed property exemptions should be included in this table.

The 20XX Ad Valorem Assessment Rolls Exemption Breakdown of ______________ County, Florida Date Certified: __________ (Every Space must be filled in. Where there are spaces that are not applicable to your county, write "NONE" or "0" in that space.)

Statutory Authority

Real Property Personal Property

DR-403EBR. xx/xxRule 12D-16.002, FACEff. xx/xx

Taxing Authority:_______________________________________________ County:___________________________ Date Certified:_______________

Column I Column II Column III Column IV

Real Property Including Personal Centrally Assessed Total

Just Value Subsurface Rights Property Property Property

1 Just Value (193.011, F.S.) 0 1

Just Value of All Property in the Following Categories

2 Just Value of Land Classified Agricultural (193.461, F.S.) 0 2

3 Just Value of Land Classified High-Water Recharge (193.625, F.S.) * 0 3

4 Just Value of Land Classified and Used for Conservation Purposes (193.501, F.S.) 0 4

5 Just Value of Pollution Control Devices (193.621, F.S.) 0 5

6 Just Value of Historic Property used for Commercial Purposes (193.503, F.S.) * 0 6

7 Just Value of Historically Significant Property (193.505, F.S.) 0 7

8 Just Value of Homestead Property (193.155, F.S.) 0 8

9 Just Value of Non-Homestead Residential Property (193.1554, F.S.) 0 9

10 Just Value of Certain Residential and Non-Residential Property (193.1555, F.S.) 0 10

11 Just Value of Working Waterfront Property (Art. VII, s.4(j), State Constitution) 0 11

Assessed Value of Differentials

12 Homestead Assessment Differential: Just Value Minus Capped Value (193.155, F.S.) 0 12

13 Nonhomestead Residential Property Differential: Just Value Minus Capped Value (193.1554, F.S.) 0 13

14 Certain Res. and Nonres. Real Property differential: Just Value Minus Capped Value (193.1555, F.S.) 0 14

Assessed Value of All Property in the Following Categories

15 Assessed Value of Land Classified Agricultural (193.461, F.S.) 0 15

16 Assessed Value of Land Classified High-Water Recharge (193.625, F.S.) * 0 16

17 Assessed Value of Land Classified and used for Conservation Purposes (193.501, F.S.) 0 17

18 Assessed Value of Pollution Control Devices (193.621, F.S.) 0 18

19 Assessed Value of Historic Property used for Commercial Purposes (193.503, F.S.) * 0 19

20 Assessed Value of Historically Significant Property (193.505, F.S.) 0 20

21 Assessed Value of Homestead Property (193.155, F.S.) 0 21

22 Assessed Value of Non-Homestead Residential Property (193.1554, F.S.) 0 22

23 Assessed Value of Certain Residential and Non-Residential Property (193.1555, F.S.) 0 23

24 Assessed Value of Working Waterfront Property (Art. VII, s.4(j), State Constitution) 0 24

Total Assessed Value

25 Total Assessed Value [Line 1 minus (2 through 11) plus (15 through 24)] 0 0 0 0 25

Exemptions

26 $25,000 Homestead Exemption (196.031(1)(a), F.S.) 0 26

27 Additional $25,000 Homestead Exemption (196.031(1)(b), F.S.) 0 27

28 Additional Homestead Exemption Age 65 and Older up to $50,000 (196.075, F.S.) * 0 28

29 Tangible Personal Property $25,000 Exemption (196.183, F.S.) 0 29

30 Governmental Exemption (196.199, 196.1993, F.S.) 0 30

31Institutional Exemptions - Charitable, Religious, Scientific, Literary, Educational (196.196, 196.197, 196.1975, 196.1977,

196.1978, 196.198, 196.1983, 196.1985, 196.1986, 196.1987, 196.1999, 196.2001, 196.2002, F.S.)0 31

32 Widows / Widowers Exemption (196.202, F.S.) 0 32

33 Disability / Blind Exemptions (196.081, 196.091, 196.101, 196.102,196.202, 196.24, F.S.) 0 33

34 Land Dedicated in Perpetuity for Conservation Purposes (196.26, F.S) 0 34

35 Historic Property Exemption (196.1961, 196.1997, 196.1998 F.S.) * 0 35

36 Econ. Dev. Exemption (196.1995, F.S.), Licensed Child Care Facility in Ent. Zone (196.095, F.S.) * 0 36

37 Lands Available for Taxes (197.502, F.S.) 0 37

38 Homestead Assessment Reduction for Parents or Grandparents (193.703, F.S.) 0 38

39 Disabled Veterans’ Homestead Discount (196.082, F.S.) 0 39

40 Deployed Service Member's Homestead Exemption (196.173, F.S.) 0 40

41 Additional Homestead Exemption Age 65 and Older and 25 yr Residence (196.075, F.S.) * 0 41

42 Renewable Energy Source Devices 80% Exemption (196.182, F.S.) 0 42

Total Exempt Value

43 Total Exempt Value (add lines 26 through 42) 0 0 0 0 43

Total Taxable Value

44 Total Taxable Value (line 25 minus 43) 0 0 0 0 44

Note: Columns I and II should not include values for centrally assessed property. Column III should include both real and personal centrally assessed values.

* Applicable only to County or Municipal Local Option Levies

The 20XX Revised Recapitulation of the Ad Valorem Assessment Roll

Value Data

Check one of the following:__ County __ Municipality__ School District __ Independent Special District

Separate reports for MSTU's, Dependent Districts, and Water Management Basins are not required

DR-403V R. xx/xx Rule 12D-16.002, F.A.C.Eff. xx/xxPage 1 of 2

County:_________________________________ Date Certified:_______________

Taxing Authority:_________________________________________________

Reconciliation of Preliminary and Final Tax Roll Taxable Value

1

2

3

4 0

5

6

7 0

Selected Just Values Just Value8

9

10

Homestead Portability11 # of Parcels Receiving Transfer of Homestead Differential

12 Value of Transferred Homestead Differential

Column 1 Column 2


Total Parcels or Accounts Parcels Accounts

13 Total Parcels or Accounts

Property with Reduced Assessed Value14 Land Classified Agricultural (193.461, F.S.)

15 Land Classified High-Water Recharge (193.625, F.S.) *

16 Land Classified and Used for Conservation Purposes (193.501, F.S.)

17 Pollution Control Devices (193.621, F.S.)

18 Historic Property used for Commercial Purposes (193.503, F.S.) *

19 Historically Significant Property (193.505, F.S.)

20 Homestead Property; Parcels with Capped Value (193.155, F.S.)

21 Non-Homestead Residential Property; Parcels with Capped Value (193.1554, F.S.)

22 Certain Residential and Non-Residential Property; Parcels with Capped Value (193.1555, F.S.)

23 Working Waterfront Property (Art. VII, s.4(j), State Constitution)

Other Reductions in Assessed Value24 Lands Available for Taxes (197.502, F.S.)

25 Homestead Assessment Reduction for Parents or Grandparents (193.703, F.S.)

26 Disabled Veterans’ Homestead Discount (196.082, F.S.)

The 20XX Revised Recapitulation of the Ad Valorem Assessment Roll

Parcels and Accounts

Note: Sum of items 9 and 10 should equal centrally assessed just value on page 1, line 1, column III.

Just Value of Centrally Assessed Private Car Line Property Value

Just Value of Subsurface Rights (this amount included in Line 1, Column I, Page One) 193.481, F.S.

Just Value of Centrally Assessed Railroad Property Value

Operating Taxable Value as Shown on Preliminary Tax Roll

Additions to Operating Taxable Value Resulting from Petitions to the VAB

Operating Taxable Value Shown on Final Tax Roll (4 + 5 - 6 = 7)

Deductions from Operating Taxable Value Resulting from Petitions to the VAB

Subtotal (1 + 2 - 3 = 4)

Other Additions to Operating Taxable Value

Other Deductions from Operating Taxable Value


DR-403VR. xx/xxPage 2 of 2

TANGIBLE PERSONAL PROPERTY TAX RETURN

CONFIDENTIAL

DR-405, R. xx-xx

Rule 12D-16.002, F.A.C.

Effective xx/xx

Enter your account number, name, and address below. Mail this form to your County Property Appraiser.

Account number

Name and address

Business name (DBA-Doing Business As) and mailing address:

If name and address is incorrect, please make needed corrections.

1. Owner or person in charge Phone

Federal Employer

Identification Number

6. Type or nature of your business

-

NAICS

Business/corporate name

2. Physical location

(no PO Boxes)

Trade levels (check all that apply) Retail Wholesale

Manufacturing Professional Service Agricultural

Leasing/rental Other, specify:

3. Do you file a TPP tax return under any other name?

Name on most recent return or tax bill

4. Date you began business in this county

Yes No 7. Did you file a TPP return in this county last year?

Name and

location

Yes No

5. Fiscal year If before 12/31 last year, does this return reflect 8. Former owner of business

end date additions/deletions through Dec 31? Yes No 9. If sold, to whom? Date sold

Personal Property Summary Schedule - Enter totals from page 2 or from an

attached itemized list or depreciation schedule with original cost and date of acquisition.

10 Office furniture, office machines, and library

11 EDP equipment, computers, and word processors

12 Store, bar and lounge, and restaurant furniture, equipment, etc.

13 Machinery and manufacturing equipment

14 Farm, grove, and dairy equipment

15 Professional, medical, dental, and laboratory equipment

16 Hotel, motel, and apartment complex

16a Rental units (stove, refrigerator, furniture, drapes, and appliances)

17 Mobile home attachments (carport, utility building, cabana, porch, etc.)

18 Service station and bulk plant equipment (underground tanks, lifts, tools)

19 Signs (billboard, pole, wall, portable, directional, etc.)

20 Leasehold improvements - grouped by type, year of installation, and description

21 Pollution control equipment

22 Equipment owned by you but rented, leased or held by others

23 Supplies not held for resale

24 Renewable energy source devices

25 Other, specify:

Taxpayer's Estimate

of Fair Market Value

Original Installed

Cost

For Property

Appraiser Use Only

TOTAL PERSONAL PROPERTY

I declare I have read this tax return and the accompanying schedules and statements. The facts in them are true. If prepared by

someone other than the taxpayer, the preparer signing this return certifies that this declaration is based on all information he or

she has knowledge of.

Signature

taxpayer Print name Title Date

Signature

preparer Print name Preparer ID Date

Address Phone

Sign and date your return, send the original to the county property appraiser’s office by April 1. Unsigned

returns cannot be accepted by the appraiser’s office. If you are entitled to a widow’s, widower’s, or disability

exemption on personal property (not already claimed on real estate), consult your appraiser.

$25,000 Less

Widowed Exemptions

Blind Taxable

Total disability Value

Other, specify

Penalties

Signature, deputy Date

Return to property appraiser by April 1 to avoid penalty.

County Tax year

TANGIBLE PERSONAL PROPERTY

Report all property owned by you including fully depreciated items still in use.

ASSETS PHYSICALLY REMOVED DURING THE LAST YEAR

DR-405, R. xx/xx , Page 2

Description Age Year Taxpayer's Estimate Original Installed Disposed, sold, or traded and to whom? Acquired of Fair Market Value Cost

LEASED, LOANED, OR RENTED EQUIPMENT Complete if you hold equipment belonging to others. Lease

Purchase Name and Address of Owner or Lessor Description Year Year of Monthly Original Installed Option

Acquired Manufacture Rent Cost Yes No

SCHEDULE FOR LINE 22, PAGE 1 Equipment owned by you but rented, leased, or held by others. Enter total on page 1.

Lease

Number

Name/address of lessee

Actual physical location Description Age

Year

Acquired

Monthly

Rent

Term

Taxpayer's

Estimate of Fair

Market Value

Cond*

Original

Installed Cost

New

SCHEDULES FOR PAGE 1, LINES 10 - 21 and 23 - 25 APPRAISER’S USE ONLY

Enter line number from page 1. Description

Age

Year Acquired

Taxpayer's Estimate

of Fair Market Value Cond*

Original Installed

Cost Cond* Value

Enter totals on page 1. TOTAL TOTAL TOTAL

Enter line number from page 1.

Description Age

Year

Acquired

Taxpayer's Estimate


Original Installed

Cost Cond* Value


Enter line number from page 1.

Description Age

Year

Acquired

Taxpayer's Estimate


Original Installed

Cost Cond* Value


*Condition: enter good, avg (average), or poor. Add pages, if needed. See instructions on pages 3 and 4.

INSTRUCTIONS DR-405, R. xx/xx, page 3

WHAT TO REPORT

Include on your return:

1. Tangible Personal Property. Goods, chattels, and

other articles of value (except certain vehicles) that

can be manually possessed and whose chief value

is intrinsic to the article itself.

2. Inventory held for lease. Examples: equipment,

furniture, or fixtures after their first lease or rental.

3. Equipment on some vehicles. Examples: power

cranes, air compressors, and other equipment used

primarily as a tool rather than a hauling vehicle.

4. Property personally owned, but used in the

business.

5. Fully depreciated items, whether written off or not.

Report at original installed cost.

Do not include:

1. Intangible Personal Property. Examples: money, all

evidences of debt owed to the taxpayer, all

evidence of ownership in a corporation.

2. Household Goods. Examples: wearing apparel,

appliances, furniture, and other items ordinarily

found in the home and used for the comfort of the

owner and his family, and not used for commercial

purposes.

3. Most automobiles, trucks, and other licensed

vehicles. See 3 above.

4. Inventory that is for sale as part of your business.

Items commonly referred to as goods, wares, and

merchandise that are held for sale. Also, inventory

is construction and agricultural equipment weighing

1,000 pounds or more that is returned to a

dealership under a rent-to-purchase option and

held for sale to customers in the ordinary course of

business. See section 192.001(11)(c), Florida

Statutes.

LOCATION OF PERSONAL PROPERTY

Report all property located in this county on January

1. You must file a single return for each site in the

county where you transact business. If you have

freestanding property at multiple sites other than

where you transact business, file a separate, but

single, return for all such property located in the

county.

Examples of freestanding property at multiple sites

include vending and amusement machines, LP/

propane tanks, utility and cable company property,

billboards, leased equipment, and similar property

not customarily located in the offices, stores, or plants

of the owner, but is placed throughout the county.

PENALTIES

Failure to file - 25% of the total tax levied against

the property for each year that no return is filed

Filing late - 5% of the total tax levied against the

property covered by that return for each year, each

month, and part of a month, that a return is late, but

not more than 25% of the total tax

Unlisted property -15% of the tax attributable to the

omitted property

RELATED FLORIDA TAX LAWS

§192.042, F.S. - Assessment date: Jan 1

§193.052, F.S. - Filing requirement

§193.062, F.S. - Filing date: April 1

§193.063, F.S. - Extensions for filing

§193.072, F.S. - Penalties

§193.074, F.S. - Confidentiality

§195.027(4), F.S.- Return Requirements

§196.183, F.S. - $25,000 Exemption

§ 837.06, F.S. - False Official Statements

See line and column instructions on page 4.

Complete this form if you own property used for commercial purposes that is not included in the assessed value of

your business' real property. This may include office furniture, computers, tools, supplies, machines, and

leasehold improvements. Return this to your property appraiser's office by April 1. Keep a copy for your records.

Report your summary totals on page 1. Use page 2 or an attached, itemized list with original cost and date

acquired for each item to provide the details for each category. Contact your local property appraiser if you

have questions.

If you ask, the property appraiser will give you an extension for 30 days and may grant an additional 15 days.

You must ask for the extension in time for the property appraiser to consider the request and act on it before

April 1.

Each return is eligible for an exemption up to $25,000. By filing a DR-405 on time you automatically apply for

the exemption. If you do not file on time, Florida Law provides for the loss of the $25,000 exemption.

DR-405, R. 12/11, Page 4

LINE INSTRUCTIONS

Within each section, group your assets by year of acquisition. List each item of property separately except for “classes”

of personal property. A class is a group of items substantially similar in function, use, and age.

Line 14 - Farm, Grove, and Dairy Equipment

List all types of agricultural equipment you owned on January 1. Describe property by type, manufacturer, model

number, and year acquired. Examples: bulldozers, draglines, mowers, balers, tractors, all types of dairy equipment,

pumps, irrigation pipe - show feet of main line and sprinklers, hand and power sprayers, heaters, discs, fertilizer

distributors.

Line 16 and 16a - Hotel, Motel, Apartment and Rental Units (Household Goods)

List all household goods. Examples: furniture, appliances, and equipment used in rental or other commercial property.

Both residents and nonresidents must report if a house, condo, apartment, etc. is rented at any time during the year.

Line 17 - Mobile Home Attachments

For each type of mobile home attachment (awnings, carports, patio roofs, trailer covers, screened porches or rooms,

cabanas, open porches, utility rooms, etc.), enter the number of items you owned on January 1, the year of purchase,

the size (length X width), and the original installed cost.

Line 20 - Leasehold Improvements, Physical Modifications to Leased Property

If you have made any improvements, including modifications and additions, to property that you leased, list the original

cost of the improvements. Group them by type and year of installation. Examples: slat walls, carpeting, paneling,

shelving, cabinets. Attach an itemized list or depreciation schedule of the individual improvements.

Line 22 - Owned by you but rented to another

Enter any equipment you own that is on a loan, rental, or lease basis to others.

Line 23 - Supplies

Enter the average cost of supplies that are on hand. Include expensed supplies, such as stationery and janitorial

supplies, linens, and silverware, which you may not have recorded separately on your books.

Include items you carry in your inventory account but do not meet the definition of “inventory” subject to exemption.

Line 24 - Renewable Energy Source Devices

List all renewable energy source devices as defined in section 193.624, Florida Statutes. Section 196.182, F.S., provides

an exemption to renewable energy source devices considered tangible personal property. The exemption is granted

based on a percentage of value, when the devices are installed, and what type of property the devices are installed on.

COLUMN INSTRUCTIONS

List all items of furniture, fixtures, all machinery, equipment, supplies, and certain types of equipment attached to mobile

homes. For each item, you must report your estimate of the current fair market value and condition of the item (good,

average, poor). Enter all expensed items at original installed cost. Do not use “various” or “same as last year” in any of

the columns. These are not adequate responses and may subject you to penalties for failure to file.

Taxpayer's Estimate of Fair Market Value

You must report the taxpayer's estimate of fair market value of the property in the columns labeled "Taxpayer's Estimate

of Fair Market Value." The amount reported is your estimate of the current fair market value of the property.

Original Installed Cost

Report 100% of the original total cost of the property in the columns labeled "Original Installed Cost." This cost includes

sales tax, transportation, handling, and installation charges, if incurred. Enter only unadjusted figures in "Original

Installed Cost" columns.

The original cost must include the total original installed cost of your equipment, before any allowance for depreciation.

Include sales tax, freight- in, handling, and installation costs. If you deducted a trade-in from the invoice price, enter the

invoice price. Add back investment credits taken for federal income tax if you deducted those from the original cost.

Include all fully depreciated items at original cost, whether written off or not.

Assets Physically Removed

If you physically removed assets last year, complete the columns in the first section of page 2. If you sold, traded, or

gave property to another business or person, include the name in the last column.

Leased, Loaned, and Rented Equipment

If you borrowed, rented, or leased equipment from others, enter the name and address of the owner or lessor in the

second section of page 2. Include a description of the equipment, year you acquired it, year of manufacture (if known),

the monthly rent, the amount it would have originally cost had you bought it new, and indicate if you have an option to

buy the equipment at the end of the term.

Property Roll

AffectedType of Exemption

Number of


Number of


1 § 196.031(1)(a) Real $25,000 Homestead Exemption 1

2 § 196.031(1)(b) Real Additional $25,000 Homestead Exemption 2

3 § 196.075 Real Additional Homestead Exemption Age 65 and Older 3

4 § 196.081 Real Totally & Permanently Disabled Veterans & Surviving Spouse 4

5 § 196.091 Real Totally Disabled Veterans Confined to Wheelchairs 5

6 § 196.095 Real Licensed Child Care Facility in Enterprise Zone 6

7 § 196.101 RealQuadriplegic, Paraplegic, Hemiplegic & Totally & Permanently Disabled

& Blind (Meeting Income Test)7

8 § 196.183 Personal $25,000 Tangible Personal Property Exemption 8

9 § 196.196 Real & Personal Constitutional Charitable, Religious, Scientific or Literary 9

10 § 196.1961 Real Historic Property for Commercial or Nonprofit Purposes 10

11 § 196.197 Real & Personal Charitable Hospitals, Nursing Homes & Homes for Special Services 11

12 § 196.1975 Real & Personal Charitable Homes for the Aged 12

13 § 196.1977 Real Proprietary Continuing Care Facilities 13

14 § 196.1978 Real & Personal Affordable Housing Property 14

15 § 196.198 Real & Personal Educational Property 15

16 § 196.1983 Real & Personal Charter School 16

17 § 196.1985 Real Labor Union Education Property 17

18 § 196.1986 Real Community Center 18

19 § 196.1987 Real & Personal Biblical History Display Property 19

20 § 196.199(1)(a) Real & Personal Federal Government Property 20

21 § 196.199(1)(b) Real & Personal State Government Property 21

22 § 196.199(1)(c) Real & Personal Local Government Property 22

23 § 196.199(2) Real & Personal Leasehold Interests in Government Property 23

24 § 196.1993 Real Agreements with Local Governments for use of Public Property 24

25 § 196.1995 Real & Personal Parcels Granted Economic Development Exemption 25

26 § 196.1997 Real Historic Property Improvements 26

27 § 196.1998 Real Historic Property Open to the Public 27

28 § 196.1999 Personal Space Laboratories & Carriers 28

29 § 196.2001 Real & Personal Non-for-Profit Sewer & Water Company 29

30 § 196.2002 Real & Personal Non-for-Profit Water & Waste Water Systems Corporation 30

31 § 196.202 Real & Personal Blind Exemption 31

32 § 196.202 Real & Personal Total & Permanent Disability Exemption 32

33 § 196.202 Real & Personal Widow's Exemption 33

34 § 196.202 Real & Personal Widower's Exemption 34

35 § 196.24 Real & Personal Disabled Ex-Service Member Exemption 35



38 § 196.173 Real Deployed Service Member's Homestead Exemption 38

39 § 196.075 Real Additional Homestead Exemption Age 65 and Older and 25 yr Residence 39

40 § 196.102 Real Totally & Permanently Disabled First Responders & Surviving Spouse 40

41 § 196.182 Personal Renewable Energy Source Devices (80% exemption) 41

Note: Centrally assessed property exemptions should be included in this table.

The 20XX Ad Valorem Assessment Rolls Exemption Breakdown of ______________ County, Florida Date Certified: __________ (Every Space must be filled in. Where there are spaces that are not applicable to your county, write "NONE" or "0" in that space.)

Statutory Authority


DR-489EB R. xx/xx Rule 12D-16.002, FACEff. xx/xx

Taxing Authority:_________________________________________________ County:___________________________ Date Certified:_______________

Column I Column II Column III Column IV

Real Property Including Personal Centrally Assessed Total

Just Value Subsurface Rights Property Property Property

1 Just Value (193.011, F.S.) 0 1

Just Value of All Property in the Following Categories

2 Just Value of Land Classified Agricultural (193.461, F.S.) 0 2

3 Just Value of Land Classified High-Water Recharge (193.625, F.S.) * 0 3

4 Just Value of Land Classified and Used for Conservation Purposes (193.501, F.S.) 0 4

5 Just Value of Pollution Control Devices (193.621, F.S.) 0 5

6 Just Value of Historic Property used for Commercial Purposes (193.503, F.S.) * 0 6

7 Just Value of Historically Significant Property (193.505, F.S.) 0 7

8 Just Value of Homestead Property (193.155, F.S.) 0 8

9 Just Value of Non-Homestead Residential Property (193.1554, F.S.) 0 9

10 Just Value of Certain Residential and Non-Residential Property (193.1555, F.S.) 0 10

11 Just Value of Working Waterfront Property (Art. VII, s.4(j), State Constitution) 0 11

Assessed Value of Differentials

12 Homestead Assessment Differential: Just Value Minus Capped Value (193.155, F.S.) 0 12

13 Nonhomestead Residential Property Differential: Just Value Minus Capped Value (193.1554, F.S.) 0 13

14 Certain Res. and Nonres. Real Property differential: Just Value Minus Capped Value (193.1555, F.S.) 0 14

Assessed Value of All Property in the Following Categories

15 Assessed Value of Land Classified Agricultural (193.461, F.S.) 0 15

16 Assessed Value of Land Classified High-Water Recharge (193.625, F.S.) * 0 16

17 Assessed Value of Land Classified and used for Conservation Purposes (193.501, F.S.) 0 17

18 Assessed Value of Pollution Control Devices (193.621, F.S.) 0 18

19 Assessed Value of Historic Property used for Commercial Purposes (193.503, F.S.) * 0 19

20 Assessed Value of Historically Significant Property (193.505, F.S.) 0 20

21 Assessed Value of Homestead Property (193.155, F.S.) 0 21

22 Assessed Value of Non-Homestead Residential Property (193.1554, F.S.) 0 22

23 Assessed Value of Certain Residential and Non-Residential Property (193.1555, F.S.) 0 23

24 Assessed Value of Working Waterfront Property (Art. VII, s.4(j), State Constitution) 0 24

Total Assessed Value

25 Total Assessed Value [Line 1 minus (2 through 11) plus (15 through 24)] 0 0 0 0 25

Exemptions

26 $25,000 Homestead Exemption (196.031(1)(a), F.S.) 0 26

27 Additional $25,000 Homestead Exemption (196.031(1)(b), F.S.) 0 27

28 Additional Homestead Exemption Age 65 and Older up to $50,000 (196.075, F.S.) * 0 28

29 Tangible Personal Property $25,000 Exemption (196.183, F.S.) 0 29

30 Governmental Exemption (196.199, 196.1993, F.S.) 0 30

31Institutional Exemptions - Charitable, Religious, Scientific, Literary, Educational (196.196, 196.197, 196.1975, 196.1977,

196.1978, 196.198, 196.1983, 196.1985, 196.1986, 196.1987, 196.1999, 196.2001, 196.2002, F.S.)0 31

32 Widows / Widowers Exemption (196.202, F.S.) 0 32

33 Disability / Blind Exemptions (196.081, 196.091, 196.101, 196.102, 196.202, 196.24, F.S.) 0 33

34 Land Dedicated in Perpetuity for Conservation Purposes (196.26, F.S) 0 34

35 Historic Property Exemption (196.1961, 196.1997, 196.1998, F.S.) * 0 35

36 Econ. Dev. Exemption (196.1995, F.S.), Licensed Child Care Facility in Ent. Zone (196.095, F.S.) * 0 36

37 Lands Available for Taxes (197.502, F.S.) 0 37

38 Homestead Assessment Reduction for Parents or Grandparents (193.703, F.S.) 0 38

39 Disabled Veterans’ Homestead Discount (196.082, F.S.) 0 39

40 Deployed Service Member's Homestead Exemption (196.173, F.S.) 0 40

41 Additional Homestead Exemption Age 65 and Older and 25 Year Residence (196.075, F.S.) * 0 41

42 Renewable Energy Source Devices 80% Exemption (196.182, F.S.) 0 42

Total Exempt Value

43 Total Exempt Value (add lines 26 through 42) 0 0 0 0 42

Total Taxable Value

44 Total Taxable Value (line 25 minus 43) 0 0 0 0 43

Note: Columns I and II should not include values for centrally assessed property. Column III should include both real and personal centrally assessed values.


The 20XX Preliminary Recapitulation of the Ad Valorem Assessment Roll

Value Data

Check one of the following:__ County __ Municipality__ School District __ Independent Special District

Separate Reports for MSTUs, Dependent Districts and Water Management Basins are not required

DR-489VR. xx/xxRule 12D-16.002, FACEff. xx/xxPage 1 of 2

County:_________________________________ Date Certified:_______________

Taxing Authority:_________________________________________________

Additions/Deletions

Just Value Taxable Value1 New Construction

2 Additions

3 Annexations

4 Deletions

5 Rehabilitative Improvements Increasing Assessed Value by at Least 100%

6 Total TPP Taxable Value in Excess of 115% of Previous Year Total TPP Taxable Value

7 Net New Value (1 + 2 + 3 - 4 + 5 + 6 = 7) 0 0

Selected Just Values Just Value8 Just Value of Subsurface Rights (this amount included in Line 1, Column I, Page One) 193.481, F.S.

9 Just Value of Centrally Assessed Railroad Property Value

10 Just Value of Centrally Assessed Private Car Line Property Value

Homestead Portability11 # of Parcels Receiving Transfer of Homestead Differential

12 Value of Transferred Homestead Differential

Column 1 Column 2


Total Parcels or Accounts Parcels Accounts

13 Total Parcels or Accounts

Property with Reduced Assessed Value14 Land Classified Agricultural (193.461, F.S.)

15 Land Classified High-Water Recharge (193.625, F.S.) *

16 Land Classified and Used for Conservation Purposes (193.501, F.S.)

17 Pollution Control Devices (193.621, F.S.)

18 Historic Property used for Commercial Purposes (193.503, F.S.) *

19 Historically Significant Property (193.505, F.S.)

20 Homestead Property; Parcels with Capped Value (193.155, F.S.)

21 Non-Homestead Residential Property; Parcels with Capped Value (193.1554, F.S.)

22 Certain Residential and Non-Residential Property; Parcels with Capped Value (193.1555, F.S.)

23 Working Waterfront Property (Art. VII, s.4(j), State Constitution)

Other Reductions in Assessed Value24 Lands Available for Taxes (197.502, F.S.)

25 Homestead Assessment Reduction for Parents or Grandparents (193.703, F.S.)

26 Disabled Veterans’ Homestead Discount (196.082, F.S.)


The 20XX Preliminary Recapitulation of the Ad Valorem Assessment Roll

Parcels and Accounts

Note: Sum of items 9 and 10 should equal centrally assessed just value on page 1, line 1, column III.

DR-489V R. xx/xxPage 2 of 2

ORIGINAL APPLICATION FOR HOMESTEAD AND RELATED TAX EXEMPTIONS

Permanent Florida residency required on January 1. Application due to property appraiser by March 1.

*Disclosure of your social security number is mandatory. It is required by section 196.011(1)(b), Florida Statutes. The social security number will be used to verify taxpayer identity and homestead exemption information submitted to property appraisers.

Continued on page 2

County Tax Year Parcel ID

I am applying for homestead exemption, $25,000 to $50,000 New Change

Do you claim residency in another county or state? Applicant? Yes No Co-applicant? Yes No

Applicant Co-applicant/Spouse

Name

*Social Security #

Immigration #

Date of birth

% of ownership

Date of permanent residency

Marital status Single Married Divorced Widowed

Homestead address

Mailing address, if different

Legal description

Phone

Type of deed Date of deed Recorded: Book Page Date

Did any applicant receive or file for exemptions last year? Yes No

Previous address:

Please provide as much information as possible. Your county property appraiser will make the final determination.

Proof of Residence Applicant Co-applicant/Spouse

Previous residency outside Florida and date terminated

date date

FL driver license or ID card number date date

Evidence of relinquishing driver license from other state

Florida vehicle tag number

Florida voter registration number (if US citizen)

date date

Declaration of domicile, enter date date date

Current employer

Address on your last IRS return

School location of dependent children

Bank statement and checking account mailing address

Proof of payment of utilities at homestead address

Yes No Yes No

Name and address of any owners not residing on the property

DR-501 R. xx/xx

Rule 12D-16.002, F.A.C

Eff. xx/xx

In addition to homestead exemption, I am applying for the following benefits. See page 3 for qualification and required documents.

By local ordinance only:

Age 65 and older with limited income (amount determined by ordinance)

Age 65 and older with limited income and permanent residency for 25 years or more

$500 widowed $500 blind $500 totally and permanently disabled

Total and permanent disability - quadriplegic

Certain total and permanent disabilities - limited income and hemiplegic, paraplegic, wheelchair required, or legally blind

Disabled veteran discount, 65 or older

Veteran disabled 10% or more

Disabled veteran confined to wheelchair, service-connected

Service-connected totally and permanently disabled veteran or surviving spouse

Surviving spouse of veteran who died while on active duty

First responder totally and permanently disabled in the line of duty or surviving spouse

Surviving spouse of first responder who died in the line of duty

Other, specify:

I authorize this agency to obtain information to determine my eligibility for the exemptions applied for. I qualify for these exemptions under Florida Statutes. I own the property above and it is my permanent residence or the permanent residence of my legal or natural dependent(s). (See s. 196.031, Florida Statutes.)

I understand that under section 196.131(2), F.S., any person who knowingly and willfully gives false information to claim homestead exemption is guilty of a misdemeanor of the first degree, punishable by imprisonment up to one year, a fine up to $5,000, or both.

I certify all information on this form and any attached statements, schedules, etc., are true and correct to the best of my knowledge as of January 1 of this year.

___________________________________________ ___________________________________ Signature, applicant Signature, co-applicant

Date Phone Date Phone

________________ ________

Signature, property appraiser or deputy Date Entered by Date

Penalties The property appraiser has a duty to put a tax lien on your property if you received a homestead exemption during the past 10 years that you were not entitled to. The property appraiser will notify you that taxes with penalties and interest are due. You will have 30 days to pay before a lien is recorded. If this was not an error by the property appraiser, you will be subject to a penalty of 50 percent of the unpaid taxes and 15 percent interest each year (see s. 196.011(9)(a), F.S.). For special requirements for estates probated or administered outside Florida, see s. 196.161(1), F.S.

The information in this application will be given to the Department of Revenue. Under s. 196.121, F.S., the Department and property appraisers can give this information to any state where the applicant has resided. Social security numbers will remain confidential under s.193.114(5), F.S.

Contact your local property appraiser or visit the Department of Revenue’s website at http://floridarevenue.com/property/

DR-501 R. xx/xx Page 2

http://floridarevenue.com/property/

EXEMPTION AND DISCOUNT REQUIREMENTS

Homestead Every person who owns real property in Florida on January 1, makes the property his or her permanent residence or the permanent residence of a legal or natural dependent, and files an application may receive a property tax exemption up to $50,000. The first $25,000 applies to all property taxes. The added $25,000 applies to assessed value over $50,000 and only to non-school taxes.

Your local property appraiser will determine whether you are eligible. The appraiser may consider information such as the items requested on the bottom of page 1.

Save our Homes (SOH) Beginning the year after you receive homestead exemption, the assessment on your home cannot increase by more than the lesser of the change in the Consumer Price Index or 3 percent each year, no matter how much the just value increases. If you have moved from one Florida homestead to another within the last two years, you may be eligible to take some of your SOH savings with you. See your property appraiser for more information.

This page does not contain all the requirements that determine your eligibility for an exemption. Consult your local property appraiser and Chapter 196, Florida Statutes, for details.

Added Benefits Available for Qualified Homestead Properties

Amount Qualifications Forms and Documents* Statute

Exemptions

Local option, age 65 and older

Determined by local ordinance

Local ordinance, limited income

Proof of age DR-501SC, household income

196.075 The amount of the

assessed value

Local ordinance, just value under $250,000, permanent residency for 25 years or more.

DR-501SC, household income

Widowed $500 Death certificate of spouse 196.202

Blind $500 Florida physician, DVA*, or SSA** 196.202

Totally and Permanently Disabled $500 Disabled Florida physician, DVA*, or SSA** 196.202

All taxes Quadriplegic 2 Florida physicians or DVA* 196.101

All taxes

Hemiplegic, paraplegic, wheelchair required for mobility, or legally blind Limited income

DR-416, DR-416B, or letters from 2 FL physicians (For the legally blind, one can be an optometrist.) Letter from DVA*, and DR-501A, household income

196.101

Veterans and First Responders Exemptions and Discount

Disabled veteran discount, age 65 and older

% of disability Combat-related disability Proof of age, DR-501DV Proof of disability, DVA*, or US government

196.082

Veteran, disabled 10% or more by misfortune or during wartime service

Up to $5,000 Veteran or surviving spouse of at least 5 years

Proof of disability, DVA*, or US government

196.24

Veteran confined to wheelchair, service-connected, totally disabled

All taxes Veteran or surviving spouse Proof of disability, DVA*, or US government

196.091

Service-connected, totally and permanently disabled veteran or surviving spouse

All taxes Veteran or surviving spouse Proof of disability, DVA*, or US government

196.081

Surviving spouse of veteran who died while on active duty

All taxes Surviving spouse Letter attesting to the veteran’s death while on active duty

196.081

First responder totally and permanently disabled in the line of duty or surviving spouse

All Taxes First responder or surviving spouse

Proof of Disability, employer certificate, physician’s certificate and SSA** (or additional physician certificate)

196.102

Surviving spouse of first responder who died in the line of duty

All taxes Surviving spouse Letter attesting to the first responder’s death in the line of duty

196.081

Department of Revenue (DR) forms are available at http://floridarevenue.com/dor/property/forms/. *DVA is the US Department of Veterans Affairs or its predecessor. **SSA is the Social Security Administration.

DR-501 R. xx/xx Page 3

http://floridarevenue.com/dor/property/forms/

DR-504 R. xx/xx

Rule 12D-16.002 FAC

Eff. xx/xx

AD VALOREM TAX EXEMPTION Application # APPLICATION AND RETURN

Sections 196.195, 196.196, 196.197, 196.1978, 196.198, 196.2001, 196.2002, Florida Statutes

This application is for ad valorem tax exemption under Chapter 196, Florida Statutes, for organizations that are organized and operate for one or more of the following purposes: (check all that apply)

Religious Literary Charitable Scientific Sewer water/Wastewater systems Educational

Hospitals, nursing homes, and homes for special services Affordable housing / Multi-Family housing

Other:

The application and return must be filed each year with the county property appraiser on or before March 1.

A. General Information

Name of organization

Mailing address

Physical address, if different

Business phone County where property is located

List all owners of the property and their proportionate interest.

% %

% %

Legal description or parcel ID

1. Is the organization incorporated? Yes No

If yes, is the organization exempt from federal income tax under

501(c)(3), I.R.C. 501(c)(12), I.R.C., Water, Wastewater Systems, 196.2002, F.S.

115(a), I.R.C. of 1954, Sewer and Water, 196.2001, F.S.

Provide a copy of the current exemption determination letter from the Internal Revenue Service.

If no, what is the form of organization?

2. Is any of this property rented or leased? Yes No

If yes, attach a copy of all active rental and lease contracts for last year.

3. Owner’s statement of full value: Real property

Real property improvements

Tangible personal property

4. How is the property used?

5. Is any portion of the property used for non-exempt purposes? Yes No If yes, provide a detailed explanation.

Add pages, if needed.

DR-504 R. xx/xx

I certify all information on this form and any attached statements, schedules, etc., are true and correct to the best of my knowledge as of January 1 of this year.

Signature Title Date

The property appraiser may require additional information to determine your eligibility for the exemption requested.

B. Hospitals, Nursing Homes, and Homes for Special Services

Organizations filing for exemption under this category must include the following information in addition to completing sections A & D.

1. Did you possess a valid license under Chapters 395, 400, or part I of Chapter 429, Florida Statutes, on January 1 of this year? Yes No

2. Have you qualified under Section 501(c)(3), United States Internal Revenue Code 1954? Yes No

C. Affordable Housing / Multi-Family Affordable Housing

Organizations filing for exemption under this category must include the following information in addition to completing sections A & D.

1. How many units are used to provide affordable housing?

2. As of January 1, have there been at least 15 completed years of the recorded agreement terms on the portion of the affordable housing property for extremely-low, very-low, or low-income limits? Yes No

3. Is the property subject to an agreement with the Florida Housing Finance Corporation? Yes No

4. Is the agreement recorded in the official records of the county? Yes No

D. Attachments You must attach the following information except when applying for exemption as an educational institution.

Every attachment must show the name and address of the organization, the date, and an identifiable heading and indicate that it is an attachment to Form DR-504.

1. If incorporated, a copy of your articles of incorporation

If not incorporated, a copy of your constitution, articles of association, declaration of trust, or other document setting your aims and purposes, including any amendments

2. A statement indicating the salaries, fees, loans, commissions, gratuities, or other compensation of any officer, director, trustee, member, or stockholder of this organization.

3. A statement indicating the guarantee of any loan to or obligation of any officer, director, trustee, member, or stockholder of this organization.

4. Any contracts between the applicant and any officer, director, trustee, member, or stockholder of this organization pertaining to:

a. rendition of service b. provision of goods or supplies c. the management of the applicant d. the construction or renovation of the applicant

5. A schedule of the following: a. salaries for the operation of the applicant b. services rendered to the applicant c. supplies and materials used by the applicant d. reserves for repair, replacement, and depreciation of the property of the applicant e. mortgage, lien, and encumbrance payments for the property of the applicant

6. A statement indicating the amounts the applicant charged for its services.

7. A statement indicating to what degree the proceeds of the sale, lease, or other disposition of the applicant’s property will inure to the benefit of the organization’s members, directors, or officers.