HomeMy WebLinkAboutHomestead_White (12)�- CLAIM FOR HOMESTEAD PROPERTY TAX
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;�'�. y : CREDIT/STANDARD DEDUCTION
;;� State Form 5473 (R2/1-90)
INSTRUCTIONS: See reverse side (or (iling instructions.
CERTIFICATION STATEMENT
FORM
HC10
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YEAR 'Z �
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I(We) � 14 C4.1 .�l%9. L�J ��4., certity that on the 1 st day of March , 19 �
I('Ne) occupied as our principal place of residence the foll ing described real property for which a Homestead
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F��rty Tax Credit is hereby claimed: 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
nrnoertv�u,is.buviraaii under a contract.
on
County
CONTRACT RECORDED
Name
recorded
PROPERTY DESCRIPTION
Townshio T�ipq Distric
8 7, � legal Description
Record Number
town, township)
If any portion of ihe residential structure or the land not ex�eeding one (1) acre that ir�ediately surrounds that struc
ture is used to produce income describe the use and portion of the property utilized io produce income.
;
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township Count T
cerlity the above slatements are true, correct and
Address (Street, number, city, state
ASSESSOR USE ONLY
ZIP code)
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements (�)
Otherland (2)
Total land - line (1) plus line (2) (3)
Residential improvemenis Dwelling (4)
Garage (5)
Other improvemenis (6)
Total improvements - line (4) through line (6) (7)
Total value - �ine (3) plus line (7) (8)
I hereby certify the above is true, Signature o( Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
I�1989 Pay1990
s;er of V2 Homestead
Valuation or $2,500
SignaWre of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
' valuation or �2,000
,
��
1991 Pay 1992
Lesser o( i/2 Homestead
Valuation or $1,500
19—Pay 19—
Lesser o( 1/2 Homestead
Valuation or $1,500
Date Signe�
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