HomeMy WebLinkAboutHomestead_Sloan��` 5i�" - CLAIM FOR HOMESTEAD PROPERTY TAX
i � CREDIT/STANDARD DEDUCTION
'� �i�• State Fortn 5473 (F2 / 5-92)
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INSTRUCTIONS: See reverse side 7or /i/ing instructions.
FORM
HC10
YEAR
01'01-
CER I TION STATEMENT
I(We) � certity that on the 7st day of March, 19_
I I(We) pied as our principal place of resid ce the foll vn g descnbed real property for which a Homestead Property Tax Credit is hereby claimed:
I(We) owned ❑ Are buying under contract
❑ Have a benefcial interest in the eniity that is liable for the properry taxes on the property and that owns the properry or is'buy'Ng'under a contrazL�
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� CONTRACT RECORDED � - � � ' ` � -`�-Y�
tl buying on contract, Fee Simple owners name . J qo00
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RemrAers aMice where coniract is recordetl " R rd number � ///�' Pa9e
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PROPERTY DESCRIP ION ' - -� __�;.�__,�.,
Counry Township Ta<ing d �ct ( ship) �"' '
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�a#(I7ymbe�� ^ � (� 'O -;�qaidescriptbn .
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If any ponion of the residen[ial sWCNre or Ne land not exceeding one (1) acre Ihat immetliatety surrounds that sWC[ure is usetl ro protluce i�ome, descnbe ffie use and ponion o(
Ne property util¢ed to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Coun - Township
I Signa ure of claimani
�reby certify the above statements are true, correct and compiete. �T—
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ddress (number and s7reeC city, slate, Z/P code) '
3 � � ro ..c� s r6 0
ASSESSOR�USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediatety (�� .
surtounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2J (3)
Dwelling (4)
Residential improvements .
Garage (5)
Other improvemenis (6)
Total improvemenis Qine 4 through line 6J Q)
Total vaiue (line 3 plus line 7) (8)
I hereby ceRify the above is true, covect, and Signature of Assesor Date signed
complete.
Veritying action - Signature of Auditor Date signed
�' STANDARD DEDUCTON ALLOWANCE
19_ Pay 79 _ .
Lesser of 1/2 Homestead �
Valuation or 52,000
Signature of AWitor Date signed