HomeMy WebLinkAboutHomestead_Ellis (7)rt.�•o
e�/'" � CLAIM FOR HOMESTEAD PROPERTY TAX
a��� CREDIT/STANDARD DEDUCTION
�;��� State Porm 5473 (R2 / 5-92)
�ai.
INSTRUCTIONS: See �everse side tor liling instfuctians.
FORM
HC10
YEAR
`J
✓
I(We) � �V - _ . _ certify Ihat on Ihe 1st day of March. 79_
'=`N ccu ietl as our principal pl of residence ihe (ollowing described rea� property tor which a Homestead Prope r@tlit is�y�Vaimed:
� H_ A �
I(We) owned ❑ Are buymg under contract }( � L`��
❑ Have a beneficial interest in the entity that is liable for the property taxes on ihe property and thai owns ihe property or is buying,under a contraci.
Counry
PROPERTY
TownShip
Taxirg
�r _ ���' � I Legal description / y7� 17��� /// ��
/1//1 �� // � f%7
11V �)�(C , e-1�./�C
of the resitlential structure or the land not exceeding one (7) acre that immetlia;ey surmuMS thai .ructure is used to produce income, descnDe the use arW portion
y utilized to produce income.
�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TownShip CounTy Township
� certify the above statemenis are tme, correct and complete. � I Sig re of
i �
(number and�er. ciry, srate. Z1P ��� �� n � L
. _ n
� ASSESSOR�USEONLY TRUETAX � ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VA�UE VALUE VALUE
Land not exceeding t(one) acre immediately
surrounding residential improvements. (�) �
Otherland � (p�
iotal land Qine 1 plus line Z� � (3)
Dwelling (4) '
Residential improvements
Garage (5) �
Other improvemenis (6) �
Total improvemenis (line 4 througb lina � (7)
Total value (line 3 p�s line � (g)
I hereby certify ihe above is irue, CorreCt, and SignaNre oi Assesmr Date siqned
complete.
Ventying aaion - Sgnawre ot Audiror Date signed
79_Pay19_
Lesserof 7l2 Homestead
valuation or $2,000
STANDARD DEDUCTION ALLOWANCE
S