HomeMy WebLinkAboutHomestead_Koberstein (11). n.,� �
e�'� g CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
ia�'� CREDIT/STANDARD DEDUCTION rtCto
.�,` � State Form 5473 (R2 / 5-92)
iei� - .
INSTRUCTIONS: See reverse side foi liling inshuctions.
4Li9�@ Q �00/i
I+We) •� � certify tl�pi9Hh��t cA�i[March, 79�
�� oc ie o � rincipal place ot residence ihe tollowing described�real pmperty for which a Homestea/c,j,.�,Pro�pert�y�Taix Credii is hereby Gaimed:
0 I(We) owned ❑ Are buying under contraci Wy�WA��1A17� T•(�1{p"l.�.y�.,�
❑ Have a beneficiai interest in the eniity that is liable for the property taxes on the property and ihat owns the propefl�VflYtlilyl�tg. �nder a contract.
� . .
CONTRACT RECORDED � �
If 6uying on contracL Fee Simple owner's name ��� _ - • , . �
Recorder's oHice�where contrect is remrded Record number Page
Caunry
ParCel number
�yll-�11 ( I
If any portion ol the residential struccure or ihe Wnd not
al the pmperty utilizetl to produce income.
PROPERTY
�
�
ng one ( 7) aue that imm
fown. townshrp)
surwunds ihat strucWre is used to produce income, tlescnbe Ne use and portion
ASSESSOR USE ONLY � TRUE TAX ASSESSED HOMESTEAD NON-RESIDEN'fIAL
VALUE VALUE VALUE VALUE
Land noi exceeding i(one) acre immediately
surrounding resideniial improvemenis. (�)
Otherland (2)
Total land (line 1 plus line 2� (g)
Dwelling (4) .
Residential improvements
Garage (5�
Other improvements (6)
7otal improvements (line 4 through lina � (7)
Total value (line 3 pbs line � (g�
I hereby cenify the above is true. correct, and S�gnamre ornssessor oaie siqnea
wmplete.
�ng aaion - Sgna.ure of Autlitor Da;e signed
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52,000
ol Autlitor
� '
STANDARD
S
Date