HomeMy WebLinkAboutHomestead_King�6 ?��
e, " f CLAIM FOR HOMESTEAD PROPERTY TAX
;; �� CREDIT/STANDARD DEDUCTION
�.,�` ,;��� Sta;e Form 5e73 (R2 / 5-92)
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INSTRUCTIONS: See reverse sidelorliling instructions.
FORM
HC10
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, I(We) \ 11 /.14 i �� . certify thai e ay o
' I(WA) occupied as our pr' pal lace of residence the fo in described re o ert for which a Homestead Pro e a. r rt is Ia ed:
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— �{We) owned Are buying under contract . . . �
.. � Have a beneficial interest in the entity ihat is liable for ihe property taxes on the property and ihat owns the property or �tIINjn��dmf8fmntraci.
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- CONTRACT RECORDED � r � -;�j j' <
It buying on contraci, Fee Simple owner's name a ( "
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Recorder's office where contract is recorded qecortl number Page
Counry
Township
PROPERTY
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e�elqurt�ber �Q ^�- oO Legal description
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If any ponion of ;he resitlential svucwre or the IarW not exceeding one (7 � aae that immetliatety surrounds that swcmre is used to produce income, tlescnbe the use and portion
of the property utilized to produce inmme.
Counry
Township
certify ihe above statements are true, correct and complete.
'numbe�randstreetary,stare.Z/PCOde) _
_ _ ASSESSOR USE ONLY
Land not exceeding t(one) acre immediately
surrounding residential improvements.
Oiher land
Total land (line 7 plus line Z�
Dwelling
Residential improvements
Garage
Oiher improvemenis
Total improvemenis (line 4 through lina �
Total value (line 3 p�s line 7�
I hereby certify the above is true, correci, and
complete.
' ��� Verifyiig aaion - SignaWre of Autlitor
79 _ Pay 79 _
Lesser of 1/2 Homestead
1 Valuation or 52,000
BY CLAIMANT IN OTHER COUNTIES
TRUETAX - I ASSESSED
VALUE VALUE
l�)
(Z)
(3)
(4)
(5)
(6)
(�)
(8)
SignaNre of Assessar
DEDUCTION ALLOWANCE
S
n
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Date signed
Dare signed
Sgnawre of Audi;or O� � Dat ig l��_ ��—I
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