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                                          Nebraska Homestead Exemption Application                                                                                                   FORM 458
                      • Nebraska Schedule I – Income Statement must be filed with this form except for categories 4 and 5.
                      • Application for Transfer must be filed by August 15 if moving to a new homestead.                                                                             2023
 File with your county assessor after February 1 and on or before June 30.                                                    Please Do Not Write In This Space
             Must File Annually For Exemption
                                Please Type or Print
 County 

             Applicant’s Name and Mailing Address                                                                              Applicant’s Date of Birth (Mo/Day/Yr)    Applicant’s Social Security Number
                                                                                                                                     /   /
                                                                                                                               Spouse’s Date of Birth (Mo/Day/Yr)       Spouse’s Social Security Number 
                                                                                                                                     /   /
                                                                                                                               Physical address of homestead residence, if different from mailing address. 

 Filing Status Applicant is: (see instructions for filing status requirements)
    Single            Married or Living with Closely-related relatives
 1 Did your spouse pass away between January 1, 2022 – December 31, 2022?  .................................             YES                                                          NO
    1a If Yes, what is your spouse’s name                                                         ____________________________ and date of death? _____/_____/_______ . 
 2 Does one of your parents, children, or siblings own and occupy this homestead?  .................................                                                           YES    NO
 3 Were you legally married as of December 31, 2022?  .......................................................                                                                   YES   NO
                                                              Homestead Exemption Categories
        • Nebraska Schedule Imust be filed for all categories except Numbers 4 and 5.       • See instructions on reverse side for specific requirements.
 1  Qualified owner-occupants age 65 and over as of January 1 of application year.
 2  Veterans totally disabled by a nonservice-connected accident or illness ( Form 458B or VA certification required; see instructions).
    Veteran’s Service Dates Beginning ______________________________ , __________ and Ending ______________________________ , __________       
                                                    (Month)             (Day)                                                 (Year)                                 (Month)    (Day)    (Year)
 3  Qualified disabled individuals (Form 458B certification required; see restrictions and instructions for qualifying conditions and certification requirements).
 4  Veterans drawing compensation from the Department of Veterans Affairs because of 100% service-connected disability, or unremarried surviving spouse
    of such a veteran (VA certification required; see instructions for certification requirement).
 5  Paraplegic veteran or multiple amputee whose home value was substantially contributed to by the Dept. of Veterans Affairs (VA certification required; see instr.)
 6  Individuals who have a developmental disability certified by the Department of Health and Human Services (Form 458B is required; see instructions).
 1 Do you currently own this residence?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES    NO
  2 Do you currently occupy this residence? .................................................................                                                                  YES    NO 
  3 If applicant is currently residing in a nursing home, please answer these questions:  ...............................
          • Have the household furnishings been removed from your residence? ........................................                                                          YES    NO
    • Is the residence currently being leased or rented by another person? ........................................                                                            YES    NO
  4 Is this homestead owned by a trust?  ....................................................................
     • If Yes, are you residing at this homestead as a beneficiary under the trust instrument per Neb. Rev. Stat. § 77-3503? ...                                               YES    NO
  5 If you received a homestead exemption last year, is the preprinted information on this form complete and correct (names, 
    Social Security numbers, birth dates, filing status, exemption category, other owner-occupants, etc.)? .................                                                   YES    NO
    •  If No, please indicate the correct information in the appropriate area.

                                                    Categories #4 and #5, skip this part.
                   Others (excluding a spouse) Who Both Own and Occupy The Residence (Attach list if necessary.)
           • Nebraska Schedule  I      — Income Statement must be filed for each owner-occupant (DO NOT repeat applicant and spouse.)
                                Name                                    Relationship to Applicant  Date of Birth (Mo/Day/Yr)                                                   Social Security Number
                                                                                                                                     /   /
           Under penalties of law, I declare that I have examined this form and that it is, to the best of my knowledge and belief, true and correct. I also declare that I am entitled 
          to the Nebraska homestead exemption and have not applied for a homestead exemption elsewhere in the state.
           I am a citizen of the United States. 
            I am a qualified alien under the Federal Immigration and Nationality Act. My immigration status and alien number are
            as follows: ____________________________  and I agree to provide a copy of my USCIS documentation upon request. 
sign
here      Signature of Applicant or Authorized Representative (required)                                                                  Date                                  Phone Number (required)
                                                              For County Assessor’s Use Only
 Legal description of homestead or physical description of mobile home: 

 Parcel or Location ID Number                  Tax District Number                                                                   Current Assessed Value of the Homestead Property

    County Approved (subject to income     Comments:
    approval by the Department of Revenue)
    County Disapproved
        Date Received by County Assessor   Signature of County Assessor                                                                                                              Date
 Nebraska Department of Revenue                                                                                                                                      Authorized by Neb. Rev. Stat. §§ 77-3510 – 3514 and 77-3528
                                       File with your county assessor after February 1 and on or before June 30.                                                                Form No. 96-295-2009 Rev. 1-2023
                                                              Retain a copy for your records.                                                                                  Supersedes 96-295-2009 Rev. 3-2022

                                                               Instructions
                                                          Instructions for Previous Filers
     Carefully review any preprinted information to ensure it is complete and correct. Make any necessary changes or additions to the 
     form in a legible manner. Answer each of the questions and sign the form. If you have any questions, contact your county assessor.
Who May File. Any individual qualifying under one of the categories listed below who, on January 1, is an owner-occupant of a residence used as 
his or her primary home, including every person who has previously been granted a homestead exemption may file a Form 458. An owner-occupant 
means: (1) the owner of record or surviving spouse (current year only); (2) the occupant purchasing and in possession of a homestead under a land 
contract; (3) one of the joint tenants, or tenants in common; or (4) the beneficiary of a trust that has an ownership interest in the homestead (see Neb.
Rev. Stat. § 77-3503). 
A homestead exemption is available to U.S. citizens or qualified aliens. Check the applicable box and indicate your alien registration number if you 
are a qualified alien. The Nebraska Homestead Exemption Information Guide is available at revenue.nebraska.gov/PAD/homestead-exemption.
When and Where to File. This form must be completed in its entirety, signed, and filed after February 1 and on or before June 30 with your county 
assessor. It is the applicant’s responsibility to secure the necessary application forms. Failure to timely file is a waiver of the homestead exemption. 
Late Filings. An applicant may file a late application no later than June 30, 2023 pursuant to Neb. Rev. Stat. 77-3514.01 if: 1) applicant includes a 
copy of the death certificate of a spouse who died during 2022; 2) applicant includes a signed Physician’s Certification for Late Homestead Exemption 
Filing, Form 458L verifying applicant was not able to timely file due to a medical condition, or 3) is granted an extension by the county board on or 
before July 20, 2022.
Filing Status. Filing status information is required to determine the income limits used to calculate the percentage of relief, if any. The filing status 
may be either be “Single, Married or Closely-Related.”
 •  Use the “Single” status if the homestead applicant filed a 2022 federal individual income tax return as “single” or “head of household” or would 
     have filed as “single” or “head of household”, if required to file a 2022 return.
 •  Use the “Married” status if the homestead applicant filed a 2022 federal individual income tax return as “married, filing jointly” or “married, 
     filing separately” or would have filed using “married, filing jointly” or “married, filing separately”, if required to file a 2022 return.
 •   Use the married filing status if you have not remarried in the year of your spouse’s death and will be filing a joint return for the year in which 
     your spouse died.
 •  Use the “Closely-Related” status if the homestead applicant would have filed a 2022 federal individual income tax return as “single” or “head 
     of household”, but lives with a brother, sister, parent, or child who is also an owner-occupant of the homestead. “Closely-Related” applicants 
     are subject to the same income criteria as “married” applicants.
Ownership and Occupancy Requirements. The person claiming a homestead exemption must own and occupy the residence (or mobile home) 
from January 1 through August 15 2023. If not owned and occupied during this time period, the homestead exemption will be disallowed for the 
entire year. If you move from one homestead in Nebraska to a new homestead in Nebraska that is acquired between January 1 and August 15 of the year 
for which the transfer is requested, contact your county assessor as soon as possible; an Application for Transfer, Form 458T, must be filed by August 15 
2023. An applicant in a nursing home may qualify for a homestead exemption if: (1) he or she intends to return to the residence; (2) the household 
furnishings have not been removed; and (3) the home has not been rented or leased.
Income Requirement.      A Nebraska Schedule I – Income Statement    must be attached, except when exemption category #4 or #5 is claimed. See 
Nebraska Schedule I instructions for income definition and levels. Failure to file the Nebraska Schedule I is a waiver of the homestead exemption.
Homestead Exemption Categories. Persons in the following categories may be considered for a homestead exemption: 
 (1) Individuals who are 65 years of age or older before January 1 2023 of the year for which application is made are eligible. The Nebraska Schedule I 
     – Income Statement must be filed each year.
 (2) Veterans who served on active duty during a recognized war of the U.S. and who are totally disabled by a non-service connected accident 
     or illness are eligible. For the first year of filing, a Certification of Disability for Homestead Exemption, Form 458B (available from the county 
     assessor), or certification from the Department of Veterans Affairs affirming the homeowner’s disability must be attached to the application for 
     homestead exemption. The Nebraska Schedule I – Income Statement must be filed with this form each year.
 (3) Qualified Disabled Individuals who have a permanent physical disability and who on or before January 1 of the application year have lost all 
     mobility that precludes the ability to walk without the use of a mechanical aid or prosthesis, or individuals who have undergone amputation of 
     both arms above the elbow, or who have a permanent partial disability of both arms in excess of 75% are eligible. 
     For the first year of filing, a Certification of Disability for Homestead Exemption, Form 458B (available from the county assessor). The Nebraska 
     Schedule I – Income Statement must be filed each year.
 (4) Disabled Veterans are eligible to have the total actual value of a homestead exempt from taxation, if they served on active duty during a recognized 
     war of the U.S. and are drawing compensation from the Department of Veterans Affairs due to: (a) a 100% service-connected disability that 
     was certified on or before January 1, 2023; (b) the service-connected death of an active duty servicemember leaving an unremarried surviving 
     spouse of this veteran or a surviving spouse who remarries after age 57; or (c) the death of any veteran who died because of a service-connected 
     disability leaving an unremarried surviving spouse or a surviving spouse who remarries after age 57. 
     For the first year of filing, a Certification from the Department of Veterans Affairs is required. Subsequent filing of a certification is at the 
     discretion of the county assessor or the Tax Commissioner.
 (5) Paraplegic or Multiple Amputee Veterans are eligible to have the total actual value of a homestead substantially contributed to by the Department 
     of Veterans Affairs exempt from taxation. If one of the following occurred on or before January 1, 2023 (a) veterans who are paralyzed in both 
     legs and cannot walk without the aid of braces, crutches, canes, or a wheelchair; (b) veterans who have undergone amputation of both lower 
     extremities or one lower and one upper extremity and cannot walk without the aid of braces, crutches, canes, a wheelchair, or artificial limbs, 
     or both upper extremities; and (c) the unremarried surviving spouse of a veteran listed in (a) or (b) above.
     For the first year of filing, a Certification from the Department of Veterans Affairs is required. Subsequent filing at the discretion of the county 
     assessor or the Tax Commissioner.
 (6) Individuals who have been certified on or before January 1, 2023 as having a developmental disability by the Department of Health and Human 
     Services as defined in section 83-1205 are eligible. For the first year of filing, a Certification of Disability for Homestead Exemption, Form 458B 
     (available from the county assessor), is required. The Nebraska Schedule I – Income Statement must be filed each year.
For categories 2 through 6; if the applicant was granted a valid homestead exemption in 2022 and no change in homestead exemption status occurred, 
then a new disability certification is not usually required; however, the county assessor or the Tax Commissioner may request a current certification 
to verify the disability.
Limitations. The homestead exemption is limited to the residence and one acre of land for all categories. Homesteads under categories 1, 2, 3, and 
6 with an assessed value exceeding the statutory maximum value will be reduced or disallowed. A percentage of the maximum exempt value of the 
homestead will be determined in accordance with the income tables. See the website (address below), or contact your county assessor for details.
Appeal Procedures.       If the application for homestead exemption is rejected by the county assessor, the applicant may request a hearing with 
the county board of equalization by filing an appeal with the county clerk. If the application for homestead exemption is rejected by the Tax 
Commissioner, the applicant may request a hearing with the Tax Commissioner by filing an appeal using Form 458P, available on the PAD website. 
All appeals must be in writing and filed within 30 days from receipt of the rejection notice. A homestead exemption appeal cannot be used to protest 
property valuations. Protests of property valuations is a separate process that occurs in June each year. Contact your county assessor for assistance.
                             For more information contact your local county assessor’s office, 
                                   or see revenue.nebraska.gov/PAD, or call 888-475-5101.