HomeMy WebLinkAboutHomestead_Wilder,y�5� CLAIM FOR HOMESTEAD PROPERTY TAX
a� ' CREDIT/STANDARD DEDUCTION
,�.� � State Form Sa73 (R2 / 5-92)
�a�
INSTRUCTIONS: See reverse side !or /iling instructions.
FORM YEAR
HC70
� . . . . >. . . . .° . . . —:: CERTIFlCATION _... . TEM 11T�, . . . � � � _ -. ". _. - •
. � � . _ , . ,-'�'.'"' > -_�:". -. . ,_ . , .
I(We) __ certify that on the 1st Gey of March, 19 f A'
i i , %,
I(We) upied as our principal place ot resid nce ihe following described real property tor which a Homestead Property Tax Credit is�heretiy.deim_d� ;1 .
A
' J I(We) owned ❑ Are buying under contract �
F�Ir�iR � 'p�n
�� Have a beneficial interesi in ihe entity that is liable for the property taxes on the property and �hat owns the property or is buying under a'coh�a7.
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,�, , ` f �/i /) /1
� � � . . _ . . - - CONTRACT RECORDED _ . . . '' - . '.: /O .G1P_Sna•..���; ��.'..`"�:-("':�"
If buying on contrad, Fee Simple owner's nama
Counry Township
I ber Legaldescnption
��3313-�.
If any portion of the resitlentia� swcture or the land not exceed
of Ne properry utilized ro produce inmme.
��PROPERTY-0ESCRI
Taxing
Record number Page
one (1) acre that immediatety surtounds that siructure is used ro produce inmme, describe Ne use arid ponion
PROPERTY OWNED BY CLAIMANT�IN OTHER COUNT7ES � � -
Counry Township Counry Township
1 hereby certify the above statements are true, correct and complete. I Sig mr of Caim� .a �
ress (number arM sbeel, city, state, ZIP code) ' 1
� . � W
. ASSESSOR USE ONLY . TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VAWE' VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately �
surrounding residential improvements. (�) �
Other land (p)
Total land Qine t plus line 7� (3)
Dwelling (4) c _ • '
Residen[ial improvements �
Garage (5� � ��
Oiher improvements (6) �
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line 7� (g)
I hereby Certi}y lhe above i5 irue, torreCt. and SgnaNre of Assesscr � Date signed
complete.
Verifyifg action - Sgnamre of Auditor Dare sgned
- � - STANDARD DEDUCTtON ALLOWANCE`� �
19 _ Pay 19
Lesser of 1/2 Homestead
Valuation or 52,000 �
Sgnamre of Audiror Date si9netl