HomeMy WebLinkAboutHomestead_Hollingsworth�a. R.,,
a��i CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
: CREDIT/STANDARD DEDUCTION HCio
.�., sy .,,�� Stare Form Sa73 (F2 / 5-92)
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INSTRUCTIONS: See reverse side 7or /iling inshuctions.
i�wb� =J%�SL(/IiCKH' l/) � _ u`�'�f � certify that on the 7 si day of March, 19_
).oecupied as our principal place�of residence the following describe real propeny for which a Homestead Property Tau b
�J I(We) owned ❑ Are buying under coniract ��,a��
❑ Have a beneticial interest in ihe entiry thai is liable for the property taxes on the properry and that owns the property or is buyi�_under a contract.
" � CONTRACTRECORDED - � � ' '
If buying on coniract, Fee Simple owner's name
` .,::jr.;i•-e ,.`):iU. " d:lfl
Recorder's oHke where contract is recordetl Record number Page
Counry
Township
- . PROPERTY
7a u ber Legal description
-o�lql-o�
If any ponion of� the resitlential strucmre or the lantl not exceeding one (7) acre that immediatey surrounds Ihat struc[ure is used ro produce income, tlescribe Ne use afM ponion
of t�e properry utilized to produce inmme.
County
�
PROPERTY OWNED BY CLAIMANi IN OTHER COUNTIES
Township ��� ^•y
certity the above statements are ime, correct and complete.
(number alld streei, ciry, stafe.
ASSESSOR USE ONLY _ TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
. VALUE VAWE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding resideniial improvements. . (�) -
Otherland (p)
7otal land (line 1 plus line 2� (3) ,
Dwelling (4) • �
Residential improvements .
Garage (5) �
Other improvements (6) -
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line 7� (g)
I hereby certify ihe above i5 We. CorreCt. and Signanre ot Asseswr Date signetl
complete.
va��ying aaion - Sgnature of Auditor Date signed
DEDUCTION ALLOWANCE
19 Pay 19 _ I
Lesser of 7/2 Homestead
Valuation or 52,000 S