HomeMy WebLinkAboutHomestead_McEllhiney (13)i���a R��°� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form Sa73 (F2/ 5-92)
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INSTRUCTIONS: See reverse side !or liling instructions.
FORM YEAR
HC10
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i(We) 17�,ly— .� 1' � � certify ih 1 on the 1st day oYMarch, 19_
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I(We) occupied as our principal place of residence the following descri d real property for which a Homestead Propetirt`yATa_x-Credit i5hereb; daimed:
❑ I(We) owned ❑ Are buying under comrect /������` �" '_..
� Have a beneficial inierest in the entity ihat is liable for the propeny ta�ces on the property and that owns the property or is buying under a contract.
,.y,: ., �, . �. �� _.�, : - . .;. ,. . ;CONTRACT.RECORDED��'.: . .: � . .. ,;�-�... .. ' ' - ' :
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It buying om m�tract, Fee Simple owner's name
Recorders office where contract is recorded Record numDer Page
Caunry
� - -� � PROPERTY DESCRIPTION ` -
Township Tauing district (cify; town, town5hip)
Parc n�m�r h��� I_ ^ Legaldescnption �/' �� ^O/�
C.% UlJ Y � � ��r
If any ponion of the residential siructure or the lantl noi ecceeding ane (1) aae that immediatey surtounds that swcture is used to
of the pmperty utilized to produce income.
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descriDe the use arM portion
' �� � PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES . �
Counry Township Counry Township
I hereby certify the above statements are true, correct and complete. Signacure laiman� ,
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�ress (number and street, ary, state, ZIP code) �
.� .ASSESSORUSEONLY "� . . 77iUETAX . ASSESSED HOMESTEAD NOM-RESIDENTIAL.
�- . � �.VALUE' � VALUE VAWE -. VALUE��- -
Land not exceeding 7(one) acre immediarely , - . " �
surrounding residential improvements. (�) �� � � �
Other land (p) ,`p' - "
7otal land (line 1 plus line 2� (3�
Dwelling (4) . � . �
Resideniial improvements . . .
Garage (g) �. - � ..
Oiher improvements (6) �
Totat improvements Qine 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby Cenify the above is tNe, corrett, and Synature of Asseswr Dare signed
complete.
Verifying aaion � Signature of Auditor Date signed
� - - _ - � _ � � STANDARD DEDUCTION ALLOWANCE � � �
79_Pay79_
Lesser of 1/2 Homestead
Valuation or $2,000
5
Sgnatura of Audiror Dare signed