HomeMy WebLinkAboutHomestead_Groves (3)���'"" - CLAIM FOR HOMESTEAD PROPERTY TAX
��° CREDIT/STANDARD DEDUCTION
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; � Siate Form 5473 (R2 / S92)
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-FORM YEAR
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Vi.iGi N y'y .��
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� INSTRUCTIONS: See reverse side /or filing instructions.
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CERTIFICATION STATEMENT � A/ - �
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I � • certify that on the tsi day of March� 9//
I(VJe) occupied as our principal place t residence the following described real property tor which a Homestead Property Ta�c Credit is hereby daimed:
We) owned ❑ Are buying under contract
Have a beneficial interest in ihe entity that is liable tor the property taxes on the properry and Ihat owns the property or is buying under a coniract.
CONTRACT RECORDED
.If buying on contraG, Fee Simple owners name
Recordels ottice where conVact is recorded Record number Page
� PROPERTY DESCRIPTION
Counry Township " Tya�ng tlistriq (riry, town, townshrp)
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Parcel number Leqal descriptlon
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If any ponion ot Ne resitlential structure or Ne land not exceeding one (1) acre that immetliatey surtountls that sWCture is usetl ro produce income, describe Ihe use and portion of
the pmperty utilizetl ro produce income.
� ' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Signature laima
�ereby certity the above statements are true, correct and complete.
Address (number and streeL ciry, state, ZIP code) .
F165 N, i'✓JJ,¢�.,_. ,S't 2vc��`�- .,�N.
ASSESSOR USE ONLY TRUE TAX ASSESSED FIOMESTEAD NON•RESIDENTIAL
VALUE VA�UE VALUE VALUE
Land not exceeding t(one) acre immediatety �� �
surrounding resideniial improvements. _ �
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
� Garege (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certity [he above is true, corrett, and Signature of Assewr Date signed
complete.
Verifying ac6on - Signature ot Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 79 _
Lesser of 1/2 Homestead S
Valuation or S2,000
Signature of Auditor Date siynetl
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