HomeMy WebLinkAboutHomestead_Lynch (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hc�o
State Form 5473 (R614-03)
Prescribed by the Depan nenl of Local Government Finance
INSTRUCTIONS: See reraraa aide for fibre :ndn.& a
I (We) certify that ynlhj'J, daffy of March, 20
(We) occupied as our principal place of resi nce the following described real property for which a Homeste�.}�rb rt (�i diI is hereby claimed:
❑ I (We) owned ❑ Are buying under contract �-yy� ?�%�
aHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns lhp?p%0eTty46 Is" yinq under a contract.
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NTRACT RECORDED# ��` �'"„:'- ��'_' �ra� `�b'�'�`��°�s:,;jy'vz^'�- -`��s
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
IN' OTHER` COUNTIES "„- ;'.e.'+9";1- �a+^^f.•`"..i`'
County
Township
Ta ing district (city, town, township)
Parcel number
Lega x
" fion
AT 700 %.OFTTV
YVALUEC'
Is the property in question:
- 0 �— 0 t9
I ❑ Real property Ile Homo (Lc. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to producdqncome. describe the use and portion
of the property utilized to produce income.
—
IN' OTHER` COUNTIES "„- ;'.e.'+9";1- �a+^^f.•`"..i`'
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Sig ature of claimant
dress (nurrkr and street, city, state, ZIP code)
/ ?W.2 C I've
SE ONLY
TA
�VAI:UEF
ASSESSED VALUE
-, HMEST
N�tESIDENTWI
NO�p�
AT 700 %.OFTTV
YVALUEC'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
c:� -"
+, aW
Other land
11 ° a%T r
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
x
- �r ° � F�
�Residential
.s
Improvements or MnuaOy
Assessed Mobile / Manufactured Home
Garage
(5)
Other improvements
(6),,
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Veifying action - Signature of Auditor
Date signed
iA.Y:'r2 a -r- �v _-._ ,
... iii �q rs'�.�.-��c°x.33e �.a�r.-= sx�v,,,- '_- `STANUAR�:DEDUCTION ALLOWANCE,., ;�r#''z.�T3s.,
20 _ Pay 20 _
Lesser of 1A2 Homestead
Vauason or 535.000 S
Signature of Auditor - Date signed