HomeMy WebLinkAboutHomestead_CotterillCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (11215 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
C.0 / ( /. Certify that on the 1st day of March, 19
as o principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
1011�(We) owned ❑. Are buying under contract ,
❑ 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.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name - -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
Count
Township
Taxing trict ow township)
5
(1)
Address (number and scree(, 6ry, state, ZIP cede)
Q- K L *.✓ C -ry LJ- % 6 d
Parcel number
00.3 -CUOaO /
Legal tle ti IF
- c:� -. . . 3 0 �e
It 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
reby certify the above statements are true, correct and complete. Signature aimant
(1)
Address (number and scree(, 6ry, state, ZIP cede)
Q- K L *.✓ C -ry LJ- % 6 d
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2.000
Signature of Auditor Date signed
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
'
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3pfu line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE '
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or $2.000
Signature of Auditor Date signed