HomeMy WebLinkAboutHomestead_Thomas (6)�� �`•,`° CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
;��� CREDIT/STANDARD DEDUCTION ' � �
HC10
� State Fartn 5473 (R2 / S92)
�L41.§�'
INSTRUCTIONS: See reverse side for filing instmctions. 't� .� �
�
CERTIFICATION STATEMEN �� ""
�p � 1
I(VJe) �°� O certify that on the 1 st day of Mamh, 79_
I(We) upied as our principal place resi ence the followin9 described real property for w ich a Home�ea �roperry au edit is hereby claimed:
❑ I(We) owned ❑ Are buying under coniract � '---�, �� T
❑ Have a beneficial interest in ihe entity that is liable for the property taues on the prop � J=an�-t o s(he Qr'opeitj% o�is buying under a contract.
CONTRACTRECORDED �
It buying on contmct, Fee Simple ownels name
Fecortlers oHice where contract is recorded � Recortl number Page
� PROPERTY DESCRIPTION
Counry Township Tadng disirict (ciry, town, mwnship) -
Pprcel umber _ legal descnp o , ` ` � � � � y
� i�i �
I( any pomon of Ne residential strucWre or ihe lantl not ezc eduig one (1) acre that immediately surrounds Nat structure is used m protluce income, deunbe e use and portion of
the properry utilized to produce income.
PROPERTV OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Sign [ure ot cl " t
�>reby certiry the above statements are true, correct and complete.
Adtlress (numberaMstBeG city, state, ZlPcode) �, -
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediatety (��
surrounding residential improvements.
Otherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4) �
Residential improvements
Garage (5)
Other improvemenis (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby Certify lhe above is true, COrtecl, and Signature ol assesor Date signea
complete.
Veritying acGon - Signature of Autliror Date signed
STANDARD DEDUCTION AILOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead S
Valuation or 52,000
Signature ol Audiror oate signed