HomeMy WebLinkAboutHomestead_Carithers`�� CLAIM FOR HOMESTEAD PROPERTY TAX
ry y CREDIT/STANDARD DEDUCTION
�,, • State Fortn 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side !or filing instructions.
� ..�n . � . . � - . -:::�CERTIFlQATI
y
FORM
HC10
YEAR
i �we� � •��1C.Lix:i�,c�.l-I- (�1�%�11.�-. �e�'Ntl''aY°6"'f999°ay of March, 79_
I(We) occu d as our pri cipal place of residence the tollovrin� I property tor whicli a Homestead Property Tax Credit is hereby daimed:
n I(We) o ned ❑ Are buying under coniract •' .__ �
L�c_.� ....
�Have a beneticial interest in the entity thai is liable for the property taxes on [he property and thalo �sdNe,pmperty}or� h�yi�un er a contreci.
�, , .. . , � .. �-'.-'• �.. _ CONTRACTRECORDED -; �...�:: � ��- ,:.. ,�:. .. •.'_e,� .,�.:;,�rc",....
If huyirg on contract, Fee Simple owner's name
Recorder's oHice where contract is recorded Record number Page
� - " - - ' ' - PROPERTY DESCHIPitON �---��.1�.� F. . . ""
Counry Township 7auing disiriq (pry, town, tawnship)
P -el m Der _� Legaldescnption �
If any portion of Ihe residenual swaure or the land not exceeding one (7) aae that immediatety surrounds s ructure is used ro produce income, de
of the property utilized to produce income.
PROPERTY OWNED BY CLAIAIANT IN OTHER COUNTIES �- � �
Counry TownS�ip Counry Township
I hereby certify the above siatements are true, correct and complete. 5 n mre ot ciaimam n
/',
�ress (numberaMstree(, dty, sfale. ZlPwtle)
Ne use and portion
� ASSESSOR USE ONLY - _ . TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAC
„ YALUE VACUE YALUE . VALUE -
Land not exceeding 1(one) acre immediatety � : -��
surrounding residential improvements. (�� � � -
Other land (p) a ° � .. � q� _
7otal land (line 1 plus line 7j (3)
Dwelling (4) � .. � . .
�.
Residential improvements . -.
Gara9e (5) ..: ..
Other improvements (6) � . � -
Total improvements (line 4 through line � (7�
7otal value (line 3 pbs line � (g)
I hereby CeRify Ihe above i5 irue, Correct, and Sgnanre ol Assessor Da;e signed
complete.
Venfyirg adion � Signature of Auditor Date signed
19_Pay19_
Lesser of V2 Homestead
Valuation or $2.000
5
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