Fill and Sign the Virginia Homestead Exemption Form

HOMESTEAD DEED KNOW ALL MEN BY THESE PRESENTS, that we/I, XXX, householder(s) residing in the City/County of CCC, Virginia, do/do es certify that We/I have not heretofore at any time declared our/m y intention to claim the benefit of the homestead exemption to whi ch We/I are entitled under the Constitution of Virginia and the Laws of Virginia for such cases made and provided or select ed or set apart as and for the said Homestead Exemption, and declar e our/my intention to claim the following property and perso nal estate to be held by us/me as exempted, as provided by law. Ou r cash evaluation of this personal estate is affixed to th e articles which are designated and described as follows: Name of Householder(s): 1. XXX. Is the householder a disabled veteran entitled to c laim additional exemption under Section 34-4.1 of the Virginia Code ? No. Address of Householder(s): . County/city in which property claimed as exempt is located: City of . Description of property claimed as exempt and the a mount is: Garnished wages Amount = $ TOTAL EXEMPTION CLAIMED: $ _______________________________ XXX STATE OF VIRGINIA CITY/COUNTY OF __________________, to-wit: The foregoing Homestead Deed was acknowledged this ______ day of _____________, 2004, by XXX. ________________________ Notary Public My Commission expires: