HomeMy WebLinkAboutHomestead_Marshall (6)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (Re 14-03)
Prescribed by the Department of Local Government Finance �yy
INSTRUCTIONS: See reverse side for fifing inslmctions. 1i �} y �f
'°--ee aLI i- I%
I (We) V certify r� on the 1st day of. March, 20_
I e oocu ied as o p p � / r
(We) p princi al lace of residen ollowing described al property for which a Homestead.Prope�rty Tax.Credit is hereby claimed:
Tyit'(We) owned ❑ Are buying under contract �O GiSgOIj ,I,�� ;r'� --<-�t
\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.
NTRACT..-RECORDED
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
as
ROPERT; YDESCRIP, TION�^. �'_'. �FSe�,8s:d�- �isw„�F��_'+,.�.�.'
County
Township
Taxing distric city, town, township)
Parcel number
Legal description Is the property in question:
property ❑ Mobile Home (I.C. 61.1.7)
If any portion of the residential structure or the Land not exceeding one (1) ace that immediately surrounds that stmclure is used to produce income. describe the use and portion
of the property utilized to produce income.
surrounding residential improvements.
A'`s�lk' Rai- ''- .'''d"-PROP.ERTY,OWNEDCLAIMANT ,IN >OTHER'COUIJTIES`.,,Yk
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
1-P Evy
Address (number and street, city, state, ZIP code)
2 801C 2'y 6
ASSESSORUSE ONLY +s.' r -
TRUE TAX
VAI:UE
ASSESSED1/AL.UE.
-+• v.b (,
ATR100°wm -r v
` HOMESTEADS
"1vAL'uE
<.�. -., YC
- NON-RESIDENTIAL `
�'rya�VALUE- �t4'aa
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Otherland
(2)
n
Taal land (line 1 plus line 2)
(3)
Dwelling
(4)�f?
Residential improvements or Annually
Assessed Mobfie / Manufactured Havre
Garage
(5)
� .'L
Other improvements
(6)
'` i - ?' <;rw
Total improvements (line 4 through line 6)
(7)
Taal value (line 3 plus line 7)
(g)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
0, WO 'i`'L`i;grra�i+'�...',' -3s-;` STANDARD: DEDUCTION" ALLOWANCE.... ii ",pt= u,«p;�','p".y�.'-'°""' -"` t q
20 _ Pay 20 _
Lesser of 112 Homestead 5
Valuation or 535.000
Signature of Auditor Date signed