Sangamon County Homestead Exemption Form

• Form Content

  Supervisor of Assessments 

  200 South Ninth Street, Room 210 

  Springfield, IL 62701 

  Telephone 217-753-6805 Fax 217-535-3143 

  www.co.sangamon.il.us 

  Application for General Homestead Exemption 

  35 ILCS 200/15-175 

  I hereby certify that: 

  (Circle YES or NO) 

  YES / NO I own and occupy the property identified below as my principal residence. 

  YES / NO I have a leasehold interest in the property. (If you answer YES to this question, STOP. This is not the correct form. Call 753-6805 for assistance.) 

  YES / NO I am responsible for the payment of real estate taxes on this property. 

  YES / NO I also affirm that the structure in which I reside is NOT a mobile home on which I pay mobile home tax. 

  Parcel Number of Property: ______________________________________ 

  Township: ______________________________________ 

  Address of Property ______________________________________ 

   (City, State, ZIP) ______________________________________ 

  The date I first occupied this residence was: _________________________________________________________ I hereby affirm that I do not receive any owner occupied exemption on any other property in Illinois or any other state. If I do, the parcel number / address of the property is: ____________________________________________ _______________________________________ (State / County): _______________________________________ 

  YES / NO Are you married and live separately from your spouse? 

  If " YES", please list your spouse's name and address. 

  Name: ___________________________________________________________________ Address: ________________________________ (City / State) _______________________ This exemption may be effective on the first day of occupancy. Application is required with new ownership. 

  Signed: _____________________________________ Print Name: ______________________________________ Daytime Telephone ________________________________ Date _______________________________________ 

  Persons of age 65 or over may be eligible for additional exemptions on homestead property. Please contact the Sangamon County Board of Review if you need information about these exemptions.