HomeMy WebLinkAboutHomestead_Tinsley (2)e CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HcTo
State Form 5473 (R2 15-92)
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INSTRUCTIONS: See reverse side for filing instructions. j" -
YEAR
I (We) I.C. certify that onHTst1a@ojMh, 19
occu a r principal plate a of residence the following d s bed real property for which a Homestead Pro Reny Tax Credit ispereby claimed:
ill r
i (We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the pe(ty�o is buying'under a bonBact.
CONTRACT RECORDED-
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
. - -
PROPERTY DESCRIPTION..
C
u
Township
I reby certify the above statements are true, correct and complete.
Taxing district (city, t township)
ParcBL•gumb(— Do /, /�—O
Legal tlescription
/� /)
It any portion of the residential structure or the land not exceeding one (1) ache that immediately surrounds that structures used t produce ifcome. describe the use and portion
of the property utilized to produce income.
CZ -/3 -/0/- / - -cls
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
I reby certify the above statements are true, correct and complete.
SXo�y ure of claimant
r
Atl ess (number and streel, dry, slate, ZIP code)
_
7,1 /S-
5
I ' ASSESSOR USE ONLY
TRUETAX
ASSESSED
HOMESTEAD
NON- RESIDENTUIL...
-
VALUE
VALUE
VALUE -
VALUE
Land not exceeding 1 (one) acre immediately
-
surrounding residential improvements.
(1)
Other land
( 2)
Total land (line i plus line 2)
(3)
Dwelling
(4)
-
Residential improvements
-
Garage
(6)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pbs line 7)
(6)
1 hereby certify the above is true. correct, and
Signature of Assessor
Date signed
complete.
VPrfying action - Signature of Auditor
Date signed
- STANDARD DEDUCTION ALLOWANCE'°
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or 52,000
S
ure of A ditor