HomeMy WebLinkAboutHomestead_Wright (22)ai °'""
; CLAIM fOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
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State Porm 5473 (R2 / 5-92)
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INSTRUCTIONS: See �everse side lor7iling instructions.
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I(!Ne) "_y0/_ ls r f f�� � � certify that on the�t ��(�r6h, 19_
) oc ied as our principal place of residence the owing described real property for which a Homestead Pmperty Tax Credit is hereby Gaimed:
� I I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity thai is liable for the property taxes on the propeny and that owns the property or is buying under a contract.
. � � CONTRACT RECORDED � .
If buyirg on contract, Fee Simple owner's name , � .. -
Recortler's oNice where contract is recortletl Record number Page
Parcel number Legal desc
a9-o��3�-on �
It any portion ot the residential stmcNre or the land not [
ot the pmperty utilized to produce income.
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PROPERTY DESCRIPTION
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( 7 ) acre
rown,
that strucmre is used to produce income, describe Ne use and ponion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Couniy Township
�eby certify the above siatemenis are irue, correct and complete. Signa of ciaimam .
Address (number and s(reef. aty, sfate. ZlPCOde)
. ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL .
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (� � ��
Oiherland (p)
Total land (line 1 plus line Z� (3)
Dwelling (4)
Residential improvements . .
Garage (5)
Other improvements (6)
Total improvements (line 4 through line � (7) �
Total value (line 3 p�s line 7� (g)
I hereby certify lhe above is irue, correct, and Signamre of Assessor Date signed
complete.
,�tyirg action - Signature of Audiror Date signed
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79_Pay79_
Lesser of V2 Homestead
valuation or 52.000
DEDUCTION ALLOWANCE
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Signawre ol Auditor I Date signed -
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