HomeMy WebLinkAboutHomestead_BoydCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Stela Form 5473 (R7 I 54M
Prescribed by the Dopartn"I of I-ccal Cavemrnard France
INSTRUCTIONS: Sea reverse We for Ming instructions
q3=CAnOX STAXIIIIENT..,
FORM YEAR
a) cerffy that on ff:ry of
6,
rk
a) oocupQ as our principal place of Asidence the following d4cribed r6 property for which a Homestead CIA �hM�cd�lied:
I (We) owned El Am buying under contract GIBBON COUNTY AUDITOR
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract
.y-:.`'.I k� CONTIRACTMECOFWIM,;�, M. 35i Pl 'Z
If buying an ..bact, Fee Simple awner's name
Recordees dfice where contract w recorded Record number Page
'-'PROPERTY b Esclaprnott -2
t4. M;
County
701—jap
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of dama�k
IV.
Parcel nkayd"
Legal description
Is the pmper&
. n question:
7660
Land not exceeding 1 (one) acre iffvrmxfiat*
Real prop" ❑ Mobile Home (LC. 6-1.1-7)
H any Porten of the residential structure or the land nit exceeEling one (1) acre that immediately unround3 that shx&e
is used to produce income. describe the use and portion
d the property Wbod top e&" income.
surrounding residenbal improvements.
-Col. 53 4 -CO L-3
I/
USE ONLY
t4. M;
County
4!lkdlldiiAD
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of dama�k
IV.
Maluation or 535.000
V
J77
neat on �
7701def-) RA 5 7 Oatictnd�c&.
11V
7660
Land not exceeding 1 (one) acre iffvrmxfiat*
y
I/
USE ONLY
TRUE.TAX
VAL UK
4!lkdlldiiAD
114
ICA
ASSESSOR
VALUE
�'ATA
VALUE'
Maluation or 535.000
signs m"of Ai cater
Data signed
Land not exceeding 1 (one) acre iffvrmxfiat*
41J, -•r
surrounding residenbal improvements.
Other land
(2)
Total land (Iine I plus tone 2)
(3)
Residential wnprover*nts or Annually
Dwelling
(4)
Garage
4-A2.'U M`110 Z
Assessed Mobile I ktunffactuned Home
(5)
Other improvements
(6)
Tdal improvements (fine 4 through ffm 6)
(7)
TdW value (line 3 plis Em 7)
(8)
I hereby certify the above is true, ocirrect, and
complete.
Signature of Assessor
—1Date—
Date silted
Vii" action - Signature of AMM"
signed
7.
20 Pay 20
Lesser of 112 Homestead
Maluation or 535.000
signs m"of Ai cater
Data signed