HomeMy WebLinkAboutHomestead_James (5)ei^�� CLAIM FOR HOMESTEAD PROPERTY TAX FORM 1'EAR
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CREDIT/STANDARD DEDUCTION HCio ���'
� State Form Se73 (R2 / 5-92) .'�' �p � � �
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INSTRUCTIONS: See reverse side lar liling instructions. . ��� -�
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CERTIFICATION STATEMENT �(�J�B�� ""'•'
1(We) ceriity ihai�h�t day ot�tylat�p�t9�
r�e) occupied as o principal plac f residence the following described real propeny tor which a Homesiead Property Ta�C�ait'.¢�hei�by claimed:
l (We) owned ❑ Are buying under contract � �
Have a beneLCial Imerest in the entity that is liable for the properiy taxes on the propeny and that owns the property or is buying under a wntract.
CONTRACT RECORDED
It buying on contraa. Fee Simple owner's name
Recortler's olike where convact is rewrded Recortl number Page
PROPERTV
Counry
(Uy, fown. ;ownship)
Parcelnumbe� I�I� Legaltlescr(pTe� /� � /� ��
01`l 0 l `�•°�4C
I: any portion ol the resitlential slmclure or the lantl not e.ceeding one (� 1 acre that immetliately surmuntls ihat stmcNre is used to produce inCOme, describe the use and ponion
ot the pmpetly utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County TownShfp Counry Tmvnship
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eby cenify Ihe above statemen�s are true. correct and complete. I Signa;ure of daimam
4 �c;�� .
Atloress (number antl streel. ciry. sta� ZlPcode)
,s��. �%
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately I' I ( I
surrounding residentfal improvements.
Otherland (p)
Total land (line 7 plus line 2� (g) I
Dwelling (4) I I
Residential improvements
Garage (g) (
Other improvemems I (6)
iotal improvements (line c rhrough line � (7) I I I
7otal value (line 3 p6s line 7� (g) I
I hereby certi(y �he above is true. correct. and I Signawre ol Assessor I Date signed
complete.
Ventyfng aaion � Signa:ure o� Auditor I Date signed
�
19_Payt9_
Lesser of 1/2 Homesteatl
valuation or 52.000
o� Auditoe