HomeMy WebLinkAboutHomestead_FleisherCLAIM FOR HOMESTEAD PROPERTY TAX' ppRM YEAR
i� CREDIT /STANDARD DEDUCTION HC10
State Form 54737(R215-92)
rein
INSTRUCTIONS: See reverse side for filing instructions. _
1"I U,7 My
I rWe certi hat on the 1 1 d f Mar 19
�) occupied as our principal place of residence the following described real property for which Homeste e s h r la ed:
❑ l(We)owned ❑ Are buying under contract
G18SON OU. Y aIfUTTOR
❑ 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 _.
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION -
Count
Township -.
T g di 'ct (city, to , tow_nsIt -
Parcel number
Legal de ti
i n a ant
S ature
r'
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.
-/3 -a- Soo -Doo- 3��? G 6'
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
1
+by certify the above statements are true, correct and complete.
i n a ant
S ature
r'
Address (number and street, city, state, ZIP code) ((��
o - 9 ,U
(o C7
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
-
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
-
Other land
(2)
_
Total land (line 1 plus line 2))
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
- _ -
r_.
Total value (line 3 pUs line 7)
(6)
'
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
®fymg action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
S
Valuation or S2,000
Signature of Auditor Date signed