HomeMy WebLinkAboutHomestead_AbbottCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION
State Form 5473 (R5110 -01)
Prescribed by the Department of Local Government Finance
"CERTIFICATION STATEMENT
V -27—F
t(WW:)) Llr)-fa0l[y that on the 1 st March
occupied aA�' 4114-42-
pied s our principal place Osidenc * a the following (Ascribed real property for which a Homestead Property Tax CAR[ R' d
❑ 1 (We) owned ❑ Are buying under contract
I pve a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prope
:CONTRACT:REGORDED?,4
f buying on contract. Fee Simple owners name
Recorder's office where contract is recorded Record number Page
_=sue`.;,. --PROPERT.Y.DESCRIP.Ti(jN
County
Township
Township
Taxing district (rdfy, town, township)
P cel nu tier
Legal d7�
. t
X�VAILUE!_!-_
Is the property roperty in question;
F-CO
7T-fid
.4 40
❑ Real property ❑ Mobile Home (I.C. 61.1 -7)
-LA
If any portion of the residential structure or the land not exceedi'll one (,A)a
immediately urrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
surrounding residential improvements.
— �'.
-PROlPERTY.6WNEd BY CLAIMANT IN OTHER 'COUINTIES '"
•
County
Township
jNON,-RESIDENTIAQ�
County
ITmnship
I hereby certify the above statements are true, correct and complete.
X�VAILUE!_!-_
ignat of claimant
and street, city, state, ZIP code) 69�0t, PniaiL Iri 0ot(and( 0-Ji.,
7T-fid
1477 A
-3
'p
'-I;
AXRUE-TAX�
ASSESSED - - VALUE
�HOMEISTEAD-;'
jNON,-RESIDENTIAQ�
�ASSESSOR USE ONLYA,.�
'AT.199% OFXTV�
X�VAILUE!_!-_
—VALUE?
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
L1
Dwelling
(4)
Residential improvements
Garage
1r
(5)
1Z
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
I hereby certify the above is true, correct. and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or 56,000 I S
Signature of Auditor