HomeMy WebLinkAboutHomestead_Osbornee� �"�'E CLAIM FOR HOMESTEAD PROPERTY TAX ,
_��: CREDIT/STANDARD.DEDUCTION
Siate Form 5473 (R2 / 5�92)
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INSTRUCTIONS: See reverse side tor liling instructions.
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) occupied as our principal place of residence the followingliEscril�d real pr�perty for which a Homesiead Property Tax Credii is hereby-claimed
i I(We) owned ❑ Are buying under contract. . -
❑ Have a beneticiai interest in the entity that is liable for the property taxes on the property and ihat owns ihe property or is buying under a contraci.
- � CONTRACTRECORDED . . - ' �
Ili buying on contract. Fee Simple owner's name V ' � - :
Recorders oflice where contract is recortled Record number Page
Counry
Pamel numDer
F1(��o - o �� �S - �
If any portion of the residential svucture or the
of fhe property utilized to produce income.
PROPERTY DESCRIPTION
Leqal description
lawn.
not exceeding one (7) acre that immediatety surrounds ihat swciure is used to produce income, desaibe Ne use and portion
PROPERTY
�eby certify ihe above siatements are irue, correci and complete.
� ���Adtlress(numberandstre t,a slafe,Z/PCOde) •
/�s P���.
BY CLAIMANT IN OTHER COUNTIES
Uaimani
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Township
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ASSESSOR USE ONLY TRUETAX ASSESSED, HOMESTEAD NON-RESIDENTIAL:'',.
. .VALUE VALUE VALUE VALUE .
-Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�) �
Other land (p)
Total land (line 7 plus line 2� - (3)
Dwelling (4) - �
Residential improvements �
Garage (g� - -
Other improvements ' (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s lin� � (g)
I hereby certify ihe above is irue, correct, and Sgnamre o� assessor oa,e signed
complete.
'��tyirg action - Signature of Autliror Date signed
79_ Pay 79_
Lesser of 7/2 Homestead
Valuation or 52,000
DEDUCTION ALLOWANCE
5
Date/�signed
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