HomeMy WebLinkAboutHomestead_Scherb,,. n,.�
a� ^°4 CLAIM FOR HOMESTEAD PROPERTY TAX
i���'� CREDIT/STANDARD DEDUCTION
.�.�;;; � State Porm 5473 (R2 / 5-92)
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INSTRUCTIONS: See �everse side /or filing inst�uctions.
ve) �I�! - ; • certify ihat on ihe 7 st day of March 19
��) occupied as o r rincipal place of resid ce the tollowing described real property for which a Homestead Property Tax�C(edh'is,t�� �y��,
�UUI�UR o
❑ I(We) owned ❑ Are buying under croniract ' .
❑ Have a beneficial interest in ihe entity ihai is liable for the propeny taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED. . �
It buyirg on conuaq, Fee Simple owners name � ..
Recortlets ottice where convact is recortled qecord number Page
- - � PROPERTY DESCRIPTION -
County . 7ownship - � iaeifg dis[riet (eey, town. rownship) ;
Parcel number Leqal description
(�(�-0 a )-� . -�.S � 3 ► - I -�o , a 7
I; any portion of the residen6al structure or ihe land noi exceeding one (7) arse that immetliately wrrounas that strucNre is usetl to produce i�ome, describe fhe use and porfion
ot Ne property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry Township Counry
,reby certify the abOVe statements are tme. CArrect and complete. SignaWre of claimant �
c.L.-
Address (number and sveet. ury. slafe. ZIP code)
,p 2 r�.� >�3 ���_��_ r�� ��L7A
ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediateiy
surrounding residential improvements.
Otherland
Total land (line / p/us line Z�
Dwelling
Residential improvements
Garage
Othec improvements
Total improvements (line 4 Ihrough line �
Total value (line 3 p�s line 7�
I hereby certify ihe above is true. correct, and
complete.
79_Pay19_
Lesser of V2 Homestead
Valuation or �2.000
Su]natu�e ot Audlmr
(�)
(21
(3)
(4)
(5)
(6)
(�I
(8)
TRUE TAX
VA�UE
of Asseswr
ASSESSED ' HOMESTEAD
VALUE VALUE
STANDARD DEDUCTION
5
Township
NON-RESIDENTIAL,
VALUE
Daie 5igned
Date signed
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