HomeMy WebLinkAboutHomestead_Pichony CLAIM FOR HOMESTEAD PROPERTY TAX
s CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
"- "CERTIFICATION STATEMENT!:
I (We) ��i i e'a.� �—. . �� ' S, 511' 'V certify that on the 1st day of March. 19
1 (We) occupied as our principal plai?e of residence the following scribed real property for which a Homestead Property Tax Credit is hereby claimed:
(We) awned ❑ Are buying under contract
It Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
- CONTRACT RECORDED::_
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION - ' I ;, -
Counry
Township
Taxing district (dry,
town, township)
Parcel number
Legal description
Signature of Auditor
Other land
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
-� CD
ASSESSOR ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL.
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or 32,000
Signature of Auditor
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)�r�,
-
Garage
(6)
- -
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
r STANDARD DEDUCTION ALLOWANCE'S -
19_Payl9_
Lesser of 1/2 Homestead
$
Valuation or 32,000
Signature of Auditor
Date signed
-9