HomeMy WebLinkAboutHomestead_PollockCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (RS 14-M)
Proscribed by the Departnent of Local Government Finance,
INSTRUCTIONS: See isweres &W for filing kaftcdwm
FmR YEAR
CIO
JAN 1 7 2006
'CERTIFICATION STATEMENT -.r
I (We) ciftUA elstedZof March. 20
'T&MRIMby claimed:
I (We) upied as our principal place of residence the following described real property for which a Homestead Prope ax
PIC) owned ❑ Are buying under contract
0 &:1
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.
K ONTRACT--RECORDED
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
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County
Township
I
TaDdng ct (city, town, township)
I rzai&A
Parcel number
aaq - 006a 4,- ce
I LeNewription
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Is the property in question:
1 Noteaj property ❑ Mobile Home (LC. 61.1 -7)
If 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 With, to prod" income.
z-- , 3 6 - ;i�
-VE &16WNE6rB*?
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
1�7 X
Address (numb" and street, city, state, ZIP code)
isggng " -N 1 --0
L,
ONLY-
OWE
-TRUE:TAX,�� ij,
-
WHO MESTEAD,
EY '.a.'
0 55�q
-90 �j ��j
U
W VAL ll�
U
Land not exceeding I (one) acre immediately
I * New
surrounding residential Improvements-
Other land
(2)
Total land (fine 1 plus line 2)
(3)
Dwelling
(4)
'Residential Improvements or Annually
13,-
Ametraed Mobtle / Manufactured Home
Garage
(5)
.
Other improvements
(6)
Total improvements (fine 4 through line 6)
.(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARDMEDUCTIONIALLOWANCE
20 _ Pay 20 —
Lesser of 1t2 Homestead
vauston or 535.000
Signature of Auditor
Date signed