HomeMy WebLinkAboutHomestead_Stephens (3)� :.,,E o
� �o
6
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 592)
IP/.STii�/i;T�n%/Sf SPP lPVPlSP SI(/A /Of /llI/10 I/IS7R1Ci10115.
FORM YEAR
� cio• �� k � � .
y;
k�� y a :.�
. 7_ «� ,
� MAY 8
`1 CERTIFICATION STATEME
I(We) certify in gn the TstdAy of }418r�h, 1
.�:.:.�r ✓i: � rh,��.�c-:_
I(We) occupied as our pnncipal of residence the following descr' ed real properry for which a Homesiead Prq�ertq 7au-0redit is hereby�dai ,:
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the properry taxes on the property and that owns the property or is buying under a coniract.
CONTRACTRECORDED �
If buying on crontraci, Fee Simple owners name
Recordets oftice where contract is recorded Recortl number Page
PROPERTY DESCRIPTIO
Counry Township Ta�cing d tri t i.(a ship)
Parcel number � Legal dp.5cnplion � � � � �
C'
It any ponion of Ne residential structure or the land not exceeding one (7 ) acre Nai immediatety surtounds that swcture is used to produce income. tlescnbe Ne use and ponion of
the properry utilaed to protluce income.
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry TovmShip
SI ature ^t �Ia'mant ��
� ereby certify the above statemen!s are true, correct and complete.
Address (number and street, dry, state, ZIP codeJ
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
_ VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediatety �� �
surrounding residential improvements.
Oiherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4[hrouglt line 6) (7)
Total value (line 3 plus line 7) (B)
I hereby certify the above is true, wrtect, and Signature of Assesor Date signed
complete.
Verifying action � Signature of Audimr Date signed
STANDARD DEDUCTION ALLOWANCE
i
19 Pay 79 _
Lesser of 1/2 Homestead e�
Valuation or 52,000
Signature of Auditor Date signed