HomeMy WebLinkAboutHomestead_Smith (58)„: �:.,
d%� '� CLAIM FOR HOMESTEAD PROPERTY TAX
�' i CREDITISTANDARD DEDUCTION
� State Form Sa73 (R2 / 5�92)
C•.��
INSTRUCTIONS: See reve�se side lor liling instructions.
FORM YEAR
HC10
� � ���..%
'�'.Nel_�A1�� !I+V.R l y,� 1 QJY�/vexA _ certifY��onthetstda�.ofMarch.l9_
� occupied as our princioal place of residence the lollowing described real pwpetly lor which a Homestead Properl�7a��rTe,ORsbGBY� claimed:
� � U 0”
Ll �(We) owned Ll Are buying under contract
❑ Have a beneficial interes� in Ihe entity tha� is liable for the property �axes on the property and thai owns the propetly or is buying under a contract.
� .�...
II buying on contract, Fee Simple owner's name
C�,. � �. o�.m."�
Recortler's oflice where mniraq is recorded
County
Township
PROPEHTY DESCRIPTION
T2sirg diSVic� (city. fown. toxnship)
Record numher � Page
Parcel number Legal description
o t� oa��� -�
II any portion of Ihe residential sVUCture or ihe lantl no1 exceetling one (1) acre Ihat immediatety surrounds Ihat strucNre is used to produce income, describe Ihe use and portion
ol tne pmperty utilizeC to produce income.
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry Township County Townshfp
��aby cenity the above statements are irue, correct and complete. si na re of claimani
Address numberand5heef,rjty,5lafe.ZlPCOde) � �
� 1 `l Q.�..,.
ASSESSOR USE ONLY � TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
• VALUE VALUE VALUE �ALUE
Land not exceeding 1(one) acre immediately
surroundingresideniialimprovemenis. (�)
Otherland (p) "
7otal land (line 7 p/us line 2� (3)
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Tolal improvements (line 4 lhiough line � (7)
7otal value (line 3 pUs line � (g) '
I hereby cetlity Ihe above is true, correct, and Signature of Assessar �ale signetl
complete. '
�q action - Synature ol Auditor Da�e s�gned
�`
19_Pay19_
Lesser of 1/2 Homestead
Valuation or $2,000
STANDARD DEDUCTION ALLOWANCE
$
SignaWre ol Audimr Dare signetl
�.� — � -