HomeMy WebLinkAboutHomestead_Yeryar (3)� �—`_ _
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..•n•�• CLAIM FOR HOMESTEAD.PROPERTY.TAX
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3'� y ° CREDIT/STANDARD DEDUCTION�
' State Form 5473 (R2/1-90)
�' '°,• �� lNSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
I (We) (_�,Q1k1/�kZ7 j"�t'�lL�
�(We) occupied as our rincipal place ol
Property Tax Credit is hereby ciaimed:
_ FORM
HC10
�.-15��\ _.
YEAR
�ertify that on the 1 st day of March , 19 �
owing described real property for which a Homestead
(We) owned ❑ Are buying under contract
� 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 it under a coritract.
If buying on contracL
RECORDED
Recorder's office where contract
PROPERTY DESCRIPTION
Township
Legal Description
Record Number
town,
Page
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
� hereby certify the above statemenis are irue, correct and Signature
complete. � � �
Address (Street. number. city. state and ZIP code)
ASSESSOR USE ONLY � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VAWE
land not exceeding 1(one) acre immediatety �
surrounding residential improvemenis (�)
Otherland (2)
Total land - line (1) plus line (2) (3)
Residen[ial improvements � Dwelling (4) � �
Garage (5)
Oiher improvements (6)
Total improvements - line (4) Ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 7990
Lesser of 7/2 Homestead
Valuation or 32,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7991
Lesser of 1/2 Homestead
Valuation or $2.000
�-
1991 Pay 7992 19—Pay 19—
Lesser of 1/2 Homestead Lesser of 7/2 Homestead
Valuation or 51.500 Valuation or $1,500
Date Signed