HomeMy WebLinkAboutHomestead_Skidmorea rtx� CLAIM FOR HOMESTEAD PROPERTY TAX
r CREDIT /STANDARD DEDUCTION
r <' State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
li
' - ' •T )' ERTIFICATION STATEMENT.. • - " � `
11
_ certi at t .f`s y o' liflfach, 19
I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Trax�CradiQehereby claimed:
�I (We) owned ❑ Are buying under contract iCIC- 2 J� LLUU
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns th roperty or' b g and a tract.
County
qY ;,i171T0 '
CONTRACT RECORDED
If burying on contract, Fee Simple owner's name
Recorder's office where contract is recorded
Record number
Page
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION -
County
Township
Township
Taxing district (city, town, township)
PacceJ.c�u r _�
Legal description
Q 0n— / ,.0/
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds t- hhatJstructure is used to produce income, describe the use and portion
of the property utilized to produce income.
/3- D- 0 510 - -4X�
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
Cou
Township
1 here certify the above statements are true, correct and complete.
Ignature claimant
*,less (number and street, city, state, ZIP code)
FA1
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL:
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
_ -
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
-
Garage
(5)
'
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(6)
1 hereby certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed