Additional Information That May Be Requested

1. Identification of Applicant and Property

  • Please  provide your name, social security number and date of birth. Your  spouse should be identified in section 4, even if he or she also  qualifies.
  • List the property's street address and its schedule or parcel number.
  • List the city or town, property zip code and the telephone number where you may be reached.
  • List  your mailing address here if different than your property address. If  your mailing address is not located in the same community, please attach  an explanation.
  • Life Estate

2. Age and Occupancy Requirements

Either 2A, 2B or one of the two statements in 2C must be true to qualify

2A - For Qualifying Seniors:

  • If the statement is true, check the box marked "True" and proceed to section 3.
  • If the statement is not true, you may qualify if you fall within one of the two exceptions in 2C, the occupancy exceptions.

2B - For Surviving Spouses of Senior who Previously Qualified:  

  • If the statement is true, check the box marked "True" and proceed to section 3.
  • If  statements made in a) or b) or f) are not true, you do not qualify as  "the surviving spouse of an individual who previously qualified." You  are not eligible for the exemption.
  • If  statement c), d) or e) is not true, you may qualify if you fall within  one of the two exceptions in 2C, the occupancy exceptions.

2C  - Exceptions to Occupancy Requirements: There are two exceptions to the  10-year occupancy requirement. (See Colorado statutes, 39-3-202(2)(b)  and 39-3-203(6)(a), C.R.S. for further details):

  • The qualifying senior or surviving spouse is/was confined to a hospital, nursing home or assisted-living facility.
  • The  prior home was condemned in an eminent domain proceeding by a  governmental entity, or the home was sold to the governmental entity due  to a threat of an eminent domain proceeding.
  • If  either statement, 2A or 2B, would be true if one of the above  situations had not occurred, check the appropriate box in 2C, and  proceed to section 3.
  • If prior home  was condemned, check the appropriate box, attach documentation of the  eminent domain proceeding and proceed to section 9. You must also  provide the information requested in section 5 and 6.

3. Ownership Requirements


Either 3A or B must be a true statement to qualify

3A - Title to the Property Held in Qualifying Senior's Name, Spouse's Name or Both:

  • The applicant, or the applicant's spouse, must be the owner of record.
  • For  any period in which the spouse is or was the owner of record and the  applicant was not the owner of record, the spouse must have occupied the  property as his or her primary residence with the applicant. If the  applicant's spouse is the owner of record for estate-planning purposes,  the applicant must be able to be considered an "owner" of the property  for the 10 consecutive years before the assessment date, January 1.
  • If  the applicant's spouse is the owner of record, the spouse must also  occupy the residence as his or her primary residence. Title can be held  individually, as joint tenants or as tenants in common.
  • A life estate is acceptable.
  • If the statement in 3A is true, check the box marked "True" and proceed to section 4.

Note:

  • Two  individuals who are legally married, but who own more than one piece of  residential real property, shall be deemed to occupy the same primary  residence and may claim no more than one exemption.
  • The  full amount of the exemption shall be allowed, even if with respect to  any single dwelling unit of residential real property, so long as any  owner-occupier of the residence satisfies the requirements. The fact  that any other person who does not satisfy the requirements is also an  owner of record shall not affect the amount of the exemption.

3B  - Title to Property Held in a Trust, Corporate Partnership or Other  Legal Entity: Colorado statute, 39-3-202(2)(a), C.R.S., provides an  exception to the ownership requirement for individuals who have  transferred ownership of their residence to a trust, corporate  partnership or other legal entity solely for estate- planning purposes.

  • If  the ownership has been transferred to or purchased by a trust, check  the box marked "True" and proceed to section 7. You must also provide  the information requested in section 7. To qualify, the maker of the  trust must be the qualifying senior or spouse.
  • If  the ownership has been transferred to, or has been purchased by, a  corporate partnership or other legal entity, check the box marked "True"  and proceed to section 8. You must also provide the information  requested in section 8. To qualify, the qualifying senior or spouse must  be a principal of the corporate partnership or legal entity.

4.  Name and Social Security Number of Each Additional Occupant 


Each  individual who occupies the property must be listed on the application  form (See Colorado statute, 39-3-205(2)(a)(III), C.R.S.)

The social security number must be included. The name must be listed to  ensure no one receives the exemption on more than one property. The statute requires the information be kept confidential.

4A - The Spouse's Name:

  • If your spouse occupies the property with you, provide his or her name, social security number and check the box marked "Yes."
  • If  you do not have a spouse living with you, list the name and social  security number of another occupant and check the box marked "No."

4B - Other Individuals:

  • List all other individuals, including children, who occupy the property as their primary residence.
  • If  more than three additional people occupy the property, attach an  additional sheet of paper listing the names and social security numbers.
  • Proceed to section 9 unless question(s) 5-8 apply.

5. Confinement to a Health-Care Facility


Information Required from Section 2C

5A - Provide the name of the person confined.

5B - State the location and the period of confinement.

5C -  Provide the dates confined.

5D - To qualify for the exemption, the statement must be true.    

  • a. the spouse of the person confined.
  • b. a financial dependent
  • c. the property remained unoccupied.

6. Condemnation by Eminent Domain


Information Required from Section 2C & 3B

6A - Provide the street address of the condemned property.

6B - Provide the dates of ownership of the condemned property.

6C - Provide the dates the condemned property was occupied as the primary residence

6D - Provide the date the property was condemned.

6E  - You cannot have owned another property between the condemnation and  the ownership of your current property. If you did own another property,  you do not qualify for the exemption.

6F - To qualify for the exemption, the statement must be true.

You  must attach documentation verifying the transfer. This may include the  sales contract, condemnation order and correspondence from the  governmental entity.

7. Property Owned By A Trust


Information Required from Section 3B

7A - Provide the name of the trust.

7B  - Provide the name of the maker of the trust. The maker is the person  who created the trust, not the attorney who prepared the trust.

7C - Provide the name of the trust.

7D - Provide the name of each beneficiary of the trust. Attach an additional sheet of paper if necessary.

7E - To qualify for the exemption, the statement must be true.

8. Property Owned by a Corporate Partnership or Other Legal Entity


Information Required from Section 3B

8A - Provide the name of the corporate partnership or legal entity.

8B  - Provide the name of each principal of the corporate partnership or  legal entity. Attach an additional sheet of paper if necessary.

8C - To qualify for the exemption, the statement must be true.

9. Affidavit & Signature

You must sign and date the form. If the form is signed on behalf of the  applicant by a guardian, conservator or attorney-in-fact, that person  must provide documentation of his or her authority in the form of a court order or power of attorney. If there is a contact person other than the applicant, please provide that person's name and telephone  number.