HomeMy WebLinkAboutHomestead_Vaught (3); rt�� � CLAIM FOR HOMESTEAD PROPERTY TAX
i�'�y,, '� CREDIT/STANDARD DEDUCTION
,�` + Siate Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side !or liling instructions.
FORM YEAR
HC10
1�./'�.� �, ,
.. . � . . . . . _`, CEftTIFlCATION 5TATEMENT : �'� �
I (We) _ _ certity that on
I(We) occupied as our principal place ot resi n the following described real property for ch a Homestead Pro rt
� I(We) owned ❑ Are buyin9 under contract
� Have a beneficial imerest in the entiry that is liable for the property taxes on the property and thai owns the,pr�'y,
- —� � ,,�
ot�March, 19
is h� daimed:
,.� . ._ . . - .. _� . CONTRACTRECORDED� w_ _ - _ .
If buying on contrad, Fee Simple owner's name
Recorder's oftice where contraa is recortletl Record number Pa9e
PROPERTY DESCRIP'TION '
Counry I Township Taxirg tlistrict (ciry; rown,
P �el�i�ayber��� Legal descripiion �
1
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It any portion of the resitlential structure or ihe land not exwedirg one (7) acre
of Ne property utilized to produce ir�come.
�
�� �� � �
surwunds that s[ructure is usetl m produce income, describe the use arW ponion
� ASSESSOR USE ONLY ' TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VALUE VALUE VALUE -�-
Land not exceeding 1(one) acre immediately . - ���
surrounding resideniial improvemenis. (� � . �• - °
Oiher land �z) , �� � �
Total land (line 7 plus line � �3)
Dwelling (4) , . ' .
Fiesidential impmvements -
Garaqe (g) �
Other improvements (6) �
7otal improvements (line 4 th�ough line � �7)
Total value (line 3 p�s line 7) (g)
1 hereby certify the above is true, correci, and Sgnamre o� nssessor oate signed
complete.
Ventyirg action - Sgnamre of Autliror Date signed
19_Pay19_
Lesser of 7/2 Homestead
Valuation or $2,000
Signature of Auditor
5
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