HomeMy WebLinkAboutHomestead_Mason (21)�`5i�" ° CLAIM FOR HOMESTEAD PROPERTY TAX
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� CREDIT/STANDARD DEDUCTION
����r' State Fortn 5473 (R2 / S92)
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INSTRUCTIONS: See reverse side /or liling instructions.
FORM
HC10
YEAR
l CERTIFICATION STATEMENT `J —1 - f- - �
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I(We) �"°—" � certifythaonih}!1itd�M,�,arch;l9 i�
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I(We) occupi s our prin p I place of residence ihe tollowing cribed real property for which a Homestead Prope Tax Credit is hereby claimed:
❑ I(We) owned ❑ Are buying under contract Q C � �;, 1999
❑ Have a beneficial interest in the entity that is liable for the property ta�ces on.the property and that owns the property or is buying undec a toMract.
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CONTRACTRECORDED A��AA�.. - - "` ;,�v
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It buying on conVac[. Pee Simpie owners name ' "•u"": � � . ' • • •--� �
Recortlers office where contract is recorded Record number Page
, - PROPERTY DESCRIPTION
Counry Tovmship Taacing district (city, rown, rownshipJ
Parcel mber � � Legal descripUOn �
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It any portion of the residential suucWre or ihe IarW not ezceeding one (1) acre that immediatety surrounds ihat sWCNre is usetl m prod e income, tlescribe ihe use and portion of
Ne property utilized to produce irxome.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Caunry � Townshi0 � _ Counry TownsNp
Si nature ot Gai i
.ereby certify the above statements are true, correct and complete.
Atldress (number an0 s1reeG dry, sla(e, ZIP code) �
ASSESSOR USE ONLY TRUE TAX . ASSESSED HOMESTEAD NON-RESIDENTIAL
VAIUE VALUE VALUE VALUE
Land not exceeding 1(one) acreimmediately (�)
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4) .
Residential improvemenis
Garage (5) � -
Oiher improvements (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify Ihe above is We, corrett, and SignaWre of Pssesor Date signed
wmplete.
Verilying action � Sgnature ot Audimr Date signed
STANDARD DEDUCTION ALLOWANCE
� � 19_ Pay 19 _
� Lesser of 1/2 Homestead S
Valuation or $2,000
Signature of Auditor �a/ JC�� �O '
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