HomeMy WebLinkAboutHomestead_Weber (8)' �E RIR .
e�/=" ', CLAIM FOR HOMESTEAD PROPERTY TAX
a_��= CREDIT/STANDARD DEDUCTION
�;'� State Form 5473 (fl2 / 5-92) -
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INSTRUCTIONS: See reve�se side 7or filing instructions. .
. ' - ' CERTIFICATION STATEMENT
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'e certity ay ar 79�
e) occupied as our p cipal place of residence the following described�real property for which a Horimestead Property�Dt�t�� Fy�daimed:
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I(We) owned ❑ Are buying under coniract
Have a beneficial interest in the entity that is liable for the property taxes on the property and ihat owns ihe property or is buying under a contract.
.. CONTRACT RECORDED - ��
( It buying on concracL Fee Simple owner's name • . . , . � . . ' .
Recorder's oKice where contraa is recorded Record number Page
County . . T vnship , n Taxinq tli � t(c . town, fo shlp)
l.t`J A P�•
Parcel n mber Legal description
-o� 8 �J �-a -�o� � a. yy�.
It any portion ot ihe residential stmcwre or Ne lantl not exceeding one (1) acre that immediatey surmunds [hai s[rucNre is used ro protluce
of ihe pmperty utilizetl to protluce income.
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PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES �
County Township �� Counry �— T
certity t�above statements are irue. correct and cromplete.
q�mbera�streef. ury. s1are. ZlPCOde)
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use and ponion
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAWE VALUE VALUE .
Land not exceeding t(one) acre�immediatety
surrounding residential improvements. (�)
Otherland (p�
Total land (line 1 plus line Z� (3)
. Dwelling (4)
Residential improvements
Garage (5)
Other improvemenis (6)
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line 7� (g)
I hereby certify Ihe abOVe is true, correci. and Signature ol Assessor Date signed
complete.
�fyirg action - Si9nature of Auditor Date signed
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STANDARD
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52,000
'� SgnaWre of Audiror \ (�
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