HomeMy WebLinkAboutHomestead_KunkeleE ''� � CLAIM FOR HOMESTEAD PROPERTY TAX
y�� CREDIT/STANDARD DEDUCTION
State Porm 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse sidedo� /ilrng instructions.
CERTIfICATIONBTATEMENT �
,. - � .
` FORM YEAR
HC70 �
� � �� � �
� �We) �,J�J[����/��7 �l_{�Q��C1.J��_ certify�ihatp{' ihe 7st day of' M��a"rch, 79�
,e) occupied as our principal place of residence�the tollowing described realpmperty for which a Homestead Pro �p�Y�d'we�s r�.�i�qn ed:
I (We) owned . ❑ nre buying.under contract � . _ � � _ AUDITOR o -
❑ Have a beneticial interest in the entity that is liable for ihe property taxes on the property and thai owns ihe property or is buying under a contract.
- . • CONTRACTRECORDED - � �
If buyi�g on contract. Pee Simple owner's.name ' �.
Recorders oRice where contraa is recorded Record number Page
County
Parcel number
� PROPERTY DESCRIPTION -
TownShip . - ' Ta�cing di5iric� (ciry, town. town5hrp) �
Legal description
�1(�� -�'� �r� �-voi � c ,�� rv �, r y -� � c,
It any pomon ot the residential swcture or the lantl not exceeding one (7) aae that immediatety surrounds that s[rucNre �s used m
of Ne property utilized to protluce income. ,
8
�, describe the use and portion
ASSESSOR USE ONLY TRUETA7( ASSESSED HOMESTEAD NON-RESIDENiIAL�
. VALUE VALUE VALUE VAWE
Land not exceeding t(one) acre immediately
surrounding residential improvemenis. (�)
Otherland (p)
Total land (line 7 plus line 2� (3)
Dwelling (4) I
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
1 hereby Certify ihe above is trUe, correcl, and Signamre ot Assessor Date signed
complete.
�fying attion - Synature ot Autliror Date signetl
79_Pay19_
Lesser of t/2 Homestead
Valuation or 52,000
Sgnature oi Autlitor
5