BEFORE ME, THE UNDERSIGNED AUTHORITY, on this day personally appeared the affiant/applicant whose name is shown below, who, being by me first duly sworn did on his or her or her oath depose and say that all of the answers given below are true and correct and that the property described below is his or her or her residential homestead and the only residential homestead that he or she or she claims and made application for residential homestead ad valorem tax exemption this year.
      (1)   NAME OF OWNER:
   Mailing Address:                                                                                                
   Telephone Number:                                                                                                
   Social Security No.:                                                                                                 
         (If deceased, so state)
      (2)   Legal description of property:                                                                                  
   (Attach copy of deed or other suitable proof of ownership)
      (3)   Address of property:
      (4)   Are you the sole owner of the above property?
   Yes or No
      (5)   If the answer to No. 4 is No, then state the name and address of the other owner or owners of the property.                                                                                                     
      (6)   Age of owner last January 1                
   (Attach copy of birth certificate or other suitable proof of age).
      (7)   Age of owner’s spouse last January 1                
(Attach copy of birth certificate or other suitable proof of age).
      (8)   How long has the property been used as a residential homestead?                                 
      (9)   List the name, approximate age, and the relationship to the owner of any and all persons residing on the property.                                                                                         
      (10)   Is any portion of the premises rented or used for commercial purposes? (If so, explain).
      (11)   If affiant/applicant is not the owner of the property, then state your name and address, telephone number, and relationship to the owner and briefly state why the owner is not making this application and signing this affidavit.
                                 Signature of Affiant/Applicant
      SWORN TO AND SUBSCRIBED BEFORE ME, this the                   day of             , 20__.
                                 Notary Public in and for Bowie County, Texas