HomeMy WebLinkAboutHomestead_Christie���� CLAIM FOR HOMESTEAD PROPERTY TAX
�� CREDIT/STANDARD DEDUCTION
��� Siate Form 5673 (R2! 5-92)
,•�.
� INSTRUCTIONS: See reverse side lorliling instruMions.
� .. . _ � � .- , . .� � ::-noernnwr
FORM YEAR
�q HC70
1i9 � � ! �t �
9
I(We) �� WY _ � 'e�tity th e 1st day of March, 19_
I We occu i s our ri . ���
( ) p p p p' ce of residence t e f Ilowing described real propert f r hi�.a.`�#� btq§�ea �P�apa,qy au Credit is hereby daimed:
/ _�--.-ntJ(;OIIN� . � .
rf 1(We) owned ❑ Are buying under contrac� �"'� '
�' Have a beneficial interesi in the entity ihat is liable tor the property taxes on the property and that owns ihe property or is buying under a contract.
-.'. . . ?...-. � .�•. . . CONTRACTRECORDED;'-'. .� ��.:; . �yrr . ' "
,. , � �;� ...
If buying on contrad, Fee Simple owner's name
Recorder's office where wntract is recordetl Recortl numDer Page
Counry
of
� ' PROPERTY DESCRIPTION -' "- � .� � �
Township Tarirg district (ciry, town, rownship) ��
al tlescription '
swcture or ihe antl not ezceedirig one (7) acre thai immetliately wrwunds [hat structure is used to protluce
Ke income.
� ' / � I I /
Ne use and ponion
- PROPERTY OWNED BY CLAIMANT IN OTHEii COUNTIES
Counry Township Caunty Township
I hereby certify the above statements are true, correct and complete. Sgnature ot aaimam � �
( ress (number and streeL ay, state, ZIP code)
OI iJ, I' n' ce 76
:� ASSESSOR USE ONLY '. TRUE TAX ASSESSED HOMESTEAD . � NON-RESIDENTIAL '
� � � . - VALUE VALUE � VALUE... VALUE �
Land not exceeding 1(one) acre immediately , � �
surrounding residential improvements. (�) - �'� �
c
Olher land (2) �-' � a �a' � . � `. -.
Total land (line ] plus line Z� (3�
Dwelling (4) . . -� .
Residential improvemenis
Garage (g) �
Other improvements (6) �
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby certity [he abOVe is Irue, corrEti, and Synature of Assessor Da;e signed
complete.
Ventyirg action - SgnaNre of Autliror Dare signetl
� � STANDARD DEDUCTION ACLOWANCE - `_' ;f, � � - �
19_Pay19_
Lesser of 1/2 Homestead
Valuation or $2.000 � .
SignaNre ol Auditor Date signetl