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Oft N <br /> %ma!y JoineW 2Q1 9 Application for Ad Valorem Tax Exemption! a7 (Mt <br /> Pasco County Property Appraiser www.pascopa.com PAS-PA601 <br /> 14236 6th St Ste 101,Dade City,Florida 335233411 R-12112 <br /> Land Or Lakes(813)929-2780 New Port Richey(727)847-8151 Dade city(352)521-4433 Homestead Application Type INIT <br /> Parcel Identification Number Cards HX card Use Mo HWDVT Pet MN=New,C=Change,A=Addiflonaj TS <br /> 1226 210100 00000 0020 001 001 01 01 HD <br /> Permanent FL residency required as of Jan I <br /> Name and Address M Marital Status:S,M,W,R,D,U Use codes:A,C,0,B,or T <br /> MARTINEZ ANA COTO&JOSE A N Are you receiving any residency B Homestead Exemption up to$60,000 <br /> 5024 20TH ST required exemptions anywhere $500 WdPw`S exemption <br /> N Redd Homestead within last 2 yrs? $500 Widowers exemption <br /> ZEPHYRHILLS FL 336425216 If"YES"where: $500(Disability)Regular <br /> Physical Address $6000(Disability)Service <br /> 5024 20TH STREET $5000 Surviving Spouse <br /> Notes If"NO",your last years address $500 Blind persons exemption <br /> 10-0-5 COMB HERE 9761 FOX HOLLOW RD . The following require documentation <br /> TAMPA FL 33647 Total&Permanent disability <br /> HILLSBOROUGH RENTED exemption,Quadriplegics <br /> Ownership Information Service connected total and <br /> permanent disability exemption <br /> Legal Description Percent of Ownership 100 Disabled veterans confined to <br /> SUMMER HILL SUBDIVISION Deed date wheelchair <br /> PB 31 PGS 38-39 Deed notary date <br /> LOTS 2&PORTION OF LOT 5 Deed recording date —Total and permanent disability, <br /> DESC AS COM AT NW COR OF SAID Type of deed limited income <br /> LOT 5 FOR POB TH S72DEG 05' OR Book and Page Surviving Spouse first responder <br /> NOTE:Disclosure of your Social Security number is mandatory.It Is required by auction 196.011(1),Florida Statutes.The Social Security number will <br /> be used to verify taxpayer identity Information,homestead exemption information submitted to property appraisers and Intangible tax Information <br /> submitted to the Department of Revenue. Applicant last name first MI CG-applicant last name first MI Other applicant last name first MI <br /> Proof of residence for all owners MARTINEZ ANA COTO MARTINEZ JOSE A JR <br /> Social Security No.and H.IN,at 0 code W H <br /> Give address for each owner not <br /> residing on above referenced property <br /> Phone number (813)417-8265 (813)83B-4868 <br /> Date you became a permanent resident <br /> of the State of Florida 01/01/2007 0110112007 <br /> Date of occupancy 03129/2018 03/29/2018 <br /> Florida Drivers license number C356016605510 MW54211623490 <br /> Issue date on drivers license 02/06/2015 09/2912014 <br /> Date of Birth 02111/1960 09/29/1962 <br /> Florida vehicle tag number <br /> Florida voter registration number U.S.CITZEN-NOT REGISTERED U.S.CITIZEN-NOT REGISTERED <br /> Date of registration <br /> Immigration number-or-Alien Card <br /> Issue date <br /> Declaration of domicile(OR and PG) <br /> Date of registration <br /> Previous Location <br /> Current Employer PEOPLES CHOICE REALTY UNEMPLOYED <br /> Address listed on your last IRS return 9761 FOX HOLLOW RD 9761 FOX HOLLOW RD <br /> TAMPA FL 33647 TAMPA FL 33647 <br /> RENTED RENTED <br /> Location and number for out of state or <br /> foreign country drivers NIA NIA WA NIA <br /> Location and number for out of state or NIA N/A NIA NIA <br />