HomeMy WebLinkAboutHomestead_Fougnies (3)��"� i CLAIM FOR HOMESTEAD PROPERTY TAX.
x��'� CREDIT/STANDARD DEDUCTION
.;...�i;�� State Form 5473 (R2 / 5-92) . .. . .
INSTRUCTIONS: See reverse side for tiling inst�uctions.
�) occupied as our prinfidal place of residbs(ce the following des �
lJ
❑ I(We) owned ❑ Arebuying under contract
L7 Have a beneficial interest in the entity that is liable for ihe property
FORM YEAR
� 3
„=�i=-�_ .... ' certify.that�.fke�QteL1Y1 ��(,j7y
realproperty for which a Homestead Property Tan �tl�t'I� r y Gaimed:
on the property and ihat owns the property or is buyinq under a contract.
. . CONTRACTRECORDED � . � �
If buying on contran. Fee Simple owner's name _ � � �
Recorder's oftiCe where ton.raa is recorded Record number Page
County
PROPERTY DESCRIPTION
. Taxing diStriCi (dry, tarn, town5hip) ,
�r _' n� ^ ,� ^� Legal description � � //� . � . � �
-(� 1�-1 SYI -/ 1 Y J
[/ / /� ci i �
of the residential s[ructure or the land not ezceetling one (71 acre ihac immediatety surrounds that siruaure �s used to protluce income, tlescribe the use and ponion
y utiiized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Counry TownShip
eby certify the above siatements �are true, correct and complete. Signamre ot ciaiman J�
G/.
Address (numbei and stree7, ary, state, Z(P code)
ASSESSOR USE ONLV -� TRUE TAX � ASSESSED HOMESTEAD NON-RESIDENTIAL
.VALUE VALUE VALUE VALUE
Land noi exceeding 7(one) acre immediately
surrounding residential improvemen[s. (�� -
Otherland (p)
Total Iand (line 1 plus line Z� (3)
Dwelling (4) . °
Resideniial improvements �
Gara9e (5)
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
1 hereby certih/ Ihe above is lrue, Correct, and SynaNre of Assessor Oate signed
complete.
�TM'd action - Signature of Auditor Dare signed
�
L
19_Pay79_
Lesser of ll2 Homestead
valuation or S2,000
of Auditor
STANDARD
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