HomeMy WebLinkAboutHomestead_May (3)a1. R.,
-' °, CLAIM FOR HOMESTEAD PROPERTY TAX
�;Lv���'� CREDIT/STANDARD DEDUCTION
.�.�7�yi..;;� State Form Sa73 (R2 / 592)
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INSTRUCTIONS: See reverse side 70� filing instructions. -
- . � CERTIPICATION
FORM
HC10
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��We) _/ �{�(J ��`�v�.— � / I U � ceriA.���7�• n e 7s j� � M ch. 19
�) occupied as our principal place ot res nce the following descri � real property for which a HomesteacWTO�y��� i l_ by daimed:
Ji
.J �(We) owned ❑ Are buying under contract , �, @f�(�
❑ Have a beneficial inierest in the entity ihai is liable for the property taxes on the property and that owns ihe propt%!§HPi�uyi 999�er a comraci.
If buying on coniract. Fee Simple owner's name
RetOrder'S ottice where wntract is recorded
County
CONTRACTRECORDED
� PROPERTY DESCRIPTION
Township Taxing distrkt(
Record number � Page
P rce��'. {(mber�/f�J Legal description "
�I 1 �"''��7 �O . . .
It any ponion ot ihe residential simcwre or the land not exceetling one (1) acre ihat immediatety surrounds that struaure is used to produce income, desaibe the use arW
of ihe pmperty urilized ro protluce inmme.
Counry
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
certify the above statements are irue, correct and complete.
number and streeL ciry, s(ate. ZIP cade)
�
ASSESSOR USE ONLY TRUE TAX • ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land noi exceeding 1(one) acre immediately
surrounding residential improvements. (�) �
Oiherland (p) �
Total land (line 7 plus line Z� (3) �
Dwelling (4) -
Residentiat improvements
Garage (g) .
Other improvements (6)
Total impmvements (line 4 through line � (7)
Total value (line 3 p�s line 7� (g�
I hereby tertify ihe above is irue. correCi, and Signature of Assessor Date signed
complete.
�tyirg action - Synanre of Auditor Date signed
i
STANDARD
19_Pay19_
Lesser ot V2 Homestead
Valuation or 52.000
S
Signature of Auditor / /r,.,, /j, A �/ \ ` Y r I i� n i /�_ _ I Dalcagnetl /^ 1
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