HomeMy WebLinkAboutHomestead_Combs4�` " YEAR
_��°s CLAIM FOR HOMESTEAD PROPERTY TAX ; FoRM
: CREDIT/STANDARD DEDUCTION HCio
.,��p :;� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side forliling inshuctions.
I(We) U� �� _ y� ��� t, � �%�S� certify� that o� 1� e��n plarch, 79
�) occupied as our principal place of residence the following described real property for which a Homesiead Propeny Tax Cr� is hereby Gaimed:
�, I(We) owned ❑ Are buying under contract �� [l
/t
❑ Have a beneficial interest in the entity that is liable for ihe pmperty taxes on the property and that owns ihe p[operry orfs�tiiiying`-UrW�op9 raci.
- � � • .� CONTRACT RECORDED. � . . � .
It buying on contrad. Fee Simple owner's name . � '
Recorders oHice where contract is recortled Record number Page
Township
Legal
DESCR�PTION
Tating disvict �i( ; low , fownship)
If any portion of the residenlial struciure or ihe land not ezceetling one (7) acre that immediatety surrountls Nat structure is usetl to produce income, describe ihe use and portion
of ihe property utilized to produce income. _
�- � PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry Township Counry Township
�=by certify the above statements are ime, correci and complete. S� n� re ot aim n�
Address (numb ra streef, dy slate, ZlPCOde) _ p ,
o? 02 r a�- . y�
� ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL �
� VAWE VALUE VALUE VAWE
Land noi exceeding 7(one) acre immediately •
surrounding residentiai improvements. (�) ' �
Otherland . (p)
Total land (line 1 plus line Z� (3)
Dwelling (4) � .
Residential improvements
Garage (5� . , �
Other improvemenis (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line � (8)
I hereby certify the above is true, correCL and Signature of Assessor Dare signetl
complete.
Veritying action - Signature of Auditor Date signed
� " � � � - - STANDARD DEDUCTION ALIOWANCE
19_Pay19_
Lesser of 1/2 Homestead
Valuation or $2.000 S
Sign AuCitor Date " tl � _ �