HomeMy WebLinkAboutHomestead_Davis (2)�� �T""°- CLAIM FOR HOMESTEAD PROPERTY TAX
i � CREDIT/STANDARD DEDUCTION
.
..�� StatePortn5473(R2/S92)
'�i,.
,�
INSTRUCTIONS: See reverse side lor liling instructions.
FORM
HC10
YEAR
CER CATION STATEMEN7
I(We) ce t t o t d arch, 19_
I(VJe) occupied as our pnncipat place of residence the following described real property for which a Homestead Property Tau Credit is hereby claimed:
❑ I(We) owned ❑ Are buying under contract APR 2 0 2001
❑ Have a beneficial interest in the entlty that is liable for the properry taxes on the property and that ow 1he property or is�Wrying under a contraci.
CONTRACT RECORDED' L!NTY AUDITOR
If buying on conVact. Fee Simple owners name
Recordefs office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Counry Township Ta�a� dislriq (ciry, t wn, wnshr
Par nymber ��� Legal description ���
( ��/
It any ponion of the residentlal sWCture or the IarW rwi exceedin one (1) acre ihat immediatey su u ds ihat structure is useU to protluce incwne, tle the use arW ponion ot
the pmperry uUlized ro produce income. .
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Tovmship , Counry Township
Si ture of daimani
� ereby certify the above statements are true, wrrect and complete.
Adtlress (num6er and street, dry, state, ZIP cotle)
� � � ?G
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not ezceeding 7(one) acre immediatery (��
surtoundin9 residential improvements.
Other land (2)
Total land (line 7 plus line 2) (3)
Dwelling (a)
Residential improvements
Garage (5)
O[her improvements (6) .
Total improvemenis (line 4 fhrough line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby Certify Ihe above is We, correct, and SignaWre of Assewr Date signetl
complete.
Verirying action - SignaWre of Autlitor Date signed
STANDARD DEDUCTION AILOWANCE
19_ Pay 19 _
Lesser of 7/2 Homestead S .
Valuation or 52,000
Signat e fAudimr �a��J�'�O J/
�L. /\
r v