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HomeMy WebLinkAboutHomestead_Blackburn (5)d..�p•, CLAIM FOR HOMESTEAD PROPERTY TAX �-y ` CREpIT/STANDARD DEDUCTION � .' State Form 5473 (R2/t-90) - �'°�• � INSTRUCTIONS: See reverse side for liling instructions. I (we) CERTIFICATION STATEMENT ►Z►i�i�1111��� . � � �� ' T � IY]I;G, that on the 1 st day DEC 7 1992 ((We) occupied � our principal place oi residence the following described real property for which a Homestead Property Tax Credit is hereby claimed: ��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 contract. CONTRACT RECORDED If buying on contract. Fee Simple Owner's Name Recorder's office where contract is recorded Record Number Page PROPERTY D Legal town, township) If any portion of tFie residential structure or ihe land not exceeding one (1) acre that imm�diatel�'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 Township County � � hereby certify ihe above statemenis are true. correci and Address (Street. number, city, state and ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land notezceeding 1(one)acreimmediately � surrounding residential improvemenis (�) ' Oiherland � (2) Total land - line (1) plus line (2) (3) � � Residential improvements Dwelling (4) � � � � - Garage (5) Other improvements (6) Total improvemenis - line (4) through line (6) (7) Total value - line (3) plus line (7) (8) I hereby certify ihe above is true, Signature o( Assesor Date Signed correct, and complete Verifying Action - Signature of Auditor Date Signed : 1989 Pay 1990 Lesser of 7/2 Homestead Valuation or $2,500 Signature of Auditor STANDARD DEDUCTION ALLOWANCE 1990 Pay 7991 Lesser of 1/2 Homestead Valuation or S2.000 � 1991 Pay 1992 Lesser of 1/2 Homestead Valuation or �1.500 79—Pay 19— Lesser of 1/2 Homestead Valuation or �,1,500 Date : � �'. �