HomeMy WebLinkAboutHomestead_Anderson (4)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
'� •. State Form 5473 (R5110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for (ling instructions.
I (We) V �fBfy that on the 1 st day of March, 20_
I (1Ne�ccupied as our ncipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
^CJ /I (We) owned ❑ Are buying under contract ' ^'s 1�'
gave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or isiQ'ng under a co Ea
z- -
n.*. - - CONTRACT�RECORDED�� '"��- '.��'�#.`•�.'a� -�.r =��"`�.��ac'�r:1 �`dz'•e.e-
If buying on contract, Fee Simple owners name -
t�
Recorders office where contract is recorded Record nilmbei'"•'�'� i a
a1350N COU TY AUDITOR
PR
" .IO - - .. °.
T."s�T
County
Toxnship
T
ist Vily town, township
to .VAL:UE t...
leeal option
400;1VAWE..
Is the property in ques'
U
U
I property ❑ Mobile Home (I.C. 6-1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately
surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Cy - Id -J'5--Aldo - i Aa
• � i
;•A `'%ASSESSOR USE ONLY ��
''`.ti ''`r:
County Township
County Tovnship
hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city, state, ZlP code)
\ \
• � i
;•A `'%ASSESSOR USE ONLY ��
''`.ti ''`r:
'w+�yTRUETAX�5
,y
ASSESSED VALUE
HOMESTEAD•''
•'
NON-RESIDENTIAL
k�
h• •: .. °g,''c4 aEc' � '."'°'��...: .. x" .
to .VAL:UE t...
ATa100�VEU
400;1VAWE..
:f, . -°-- VALUES -;.' a`h`F'xF??
Land not exceeding 1 (one) acre immediately
(1),
surrounding residential improvements.
Other land
(2)
•� f9Y•`
��•`N
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
4•t:ir" .' S
Residential improvements
Garage
(5)
� R
;°`sgS Ak�'y'
b'.� • -F,sa � -s'
Other improvements
(6)
s RE'
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plw line 7)
(6)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
M-STANDARD ;'DEUUCTION;ALCOWANCE..:�r ; aei< 4„ xa` �..; a5,-., eiz` i' '_- :6Kj�`.•y�„�;�:��._i„r_�...f
20 _ Pay 20
Lesser of 112 Homestead
Valuation or $6,000 $
Signature of Auditor Date signed