HomeMy WebLinkAboutHomestead_Corn (4)FORM YEAR
7111
It -&I-A -a 0931
DEC 31993
I (We) �.Y f �I - Ylcenify that o ht ��®p�ih, s�
�) occupied as our pr al pI c residence the followirl described real property for 1 ich a a_H_o_meestead Property Tax Credit is hereby claimed:
L-i I (We) owned ❑ Are b5u rig under contract
❑ Have a beneficial interest in the entity that Js liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
CLAIM FOR HOMESTEAD PROPERTY TAX
Towns ,ip
CREDIT /STANDARD DEDUCTION
Abe
State Form 5473(R2/5-92)
It any portion of the residential structure or the land not exceeding one (1) acre that immediately suuountll that structure is used to produce income. describe the use and portion
of the property utilized to produce incomes.
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
7111
It -&I-A -a 0931
DEC 31993
I (We) �.Y f �I - Ylcenify that o ht ��®p�ih, s�
�) occupied as our pr al pI c residence the followirl described real property for 1 ich a a_H_o_meestead Property Tax Credit is hereby claimed:
L-i I (We) owned ❑ Are b5u rig under contract
❑ Have a beneficial interest in the entity that Js liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Towns ,ip
Taxi di ric city, tow . towpship)
Parcel number
Q03-
Legal de ." ' on
It any portion of the residential structure or the land not exceeding one (1) acre that immediately suuountll that structure is used to produce income. describe the use and portion
of the property utilized to produce incomes.
Cp � of ' o�o/ Q� — �U/ • �U 'LC /f0.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true, correct and complete. Sign • r id ;m = ^
u'0
Address (number and street, city. state. ZIP code)
V
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
.
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plrs line 7)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
19 _Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
DEDUCTION ALLOWANCE
Signature of Auditor I dy\ I Date