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Homestead Application – Certification for Class 4d(2) – Homestead Community Land Trust CR-4d(2)

A unit owned by the occupant and used as a homestead by the occupant may receive a class rate of 0.75%. The Community Land Trust must continue to own the real property on which the unit is located and the unit owner must remain a member in good standing. Use this form to certify that members are in good standing. Certifications are due December 31 of the assessment year. This certification must be completed by the Community Land Trust and signed by an authorized individual.

Address

List the owners of units occupied as homestead and indicate if they are a member in good standing with the land trust.

Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?
Unit owner is a member in good standing?
Community Land Trust continues to own real property where unit is located?

Signature of Owner or Authorized Representative

By signing below, I certify that the information on this form is true and correct to the best of my knowledge, and I am the owner of the property or authorized representative of the organization that owns the property for which certification as 4d(2) is required.
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Last updated by the Pope County Assessor’s office February 28, 2024