HomeMy WebLinkAboutHomestead_Goodalli��`��"" ° CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION �
.
� Sta[e Portn Sa73 (R2 / S92)
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INSTRUCTIONS: See �everse side 7or /iling instructions.
` i� . . - � /1 CERTIFICATION STATEMENT
FORM
HC10
/
YEAR
I(VJe) r—' J�� certify th�,at� o0.th�e � t��f MaY h, 19_
I(We) occupied a ur principal place of residence the following described real pioperty for which a Homestead ProHyS`N�i a�LCfe ereb claimed:
❑ I(We) owned ❑ Are buyin9 under contract -� ��� /� �
❑ Have a beneficial interesi in the eniiry that is liable for the propeAy taxes on the property and that owns thg�roperty ec€ya�r act.
It buyirg on contract. Fee Simple ownefs name
Recordets ottice where contract is recordeA
CONTRACT RECORUED
PROPERTY DESCRIPTION
Tax'u�9 tlisirict (city,
Recordnum�er �Page
Parce� � ber � � ��� � I Legal tlescription �/ � /� / � �� // / ��
7 �. /GY/(_��
If any portion of the rev0entlal structure w.ihe land not exceedinq one (1) acre that immetliatety sunounQS that s[ructure is usetl to protluce income, tlescribe Ne use antl portion ot
the properry uviized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHEfl COUNTRIES
CouNy Township , Counry TownShip
certify the above statements are true, cortect and complete.
ASSESSOR USE ONLY
Land not ezceeding 7(one) acre immediatey
surrounding residential improvements.
Oiher land �
Total land (line 7 plus line 2)
Dwelling
Residential improvemenis
Garage
Other improvements
Total improvemenis (line 4 through line 6J
Total value (line 3 plus line 7J
I hereby certify ihe above is tr�e, correct, and
complete.
19_ Pay 19 _
Lesser of 1/2 Homestead
„ Valuation or 52,000
TRUE TAX
VALUE
(�)
iz1
(3)
(4)
(5)
(6)
I�)
(8)
STANDARD DEDUCTON ALLOWANCE
S
FiOMESTEAD I NON-RESIDENTIAL
VALUE VALUE
of Audit r I Date VeA�— �� ' O/ I
ib, 1A