HomeMy WebLinkAboutHomestead_McCandless (6)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (RB /4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
v (—/ (" t-�t. //J( --2 V- / tT A/ fly Y
(Wej L �, � cent that on the 1st des of March, 20
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(We) occupied as our ptincipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Ave buying under contract $
Have a beneficial interest in the entity that is liable for the property taxes on the property and that o th- p pe or is Wng de contract.
zCONTRACTRE_ _C_OR_DED_'
na
If buying on contract, Fee Simple owners name
n
Recorders office where contract is recorded
R nym age
SIi3 nnI r`nUNTY AUDITOR
^-zt� u' ? �.'P C .rSTANUARD.DEDUCTION'gLLOWAMCE
20_ Pay 20_
Lesser of 112 Homestead
u ton or S35. S
Signature of Auditor Daatt�e'"gned _��
�?k,,. .v�PROP,ERTY<DESCRIP.TION"`�r,�
Coun
SOW����
i
Testing ii ct (city, town, township)
Parcel number j}�
403- oa( 'QS- 0 D
egal description '3,
S 3I- - .2- 0.c
Is the prope i question
Roal DrtipeM ❑ MobBOHomo(I.C.61.1-7)
if any potion 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.
HOMESTEAD -'`
..- tNONvRES1DENTIAL
D -ODD. Qom- co
^-zt� u' ? �.'P C .rSTANUARD.DEDUCTION'gLLOWAMCE
20_ Pay 20_
Lesser of 112 Homestead
u ton or S35. S
Signature of Auditor Daatt�e'"gned _��
County Township
County Township
I hereby certify the above statements are We, correct and complete.
Sig re of claimant
C
Address (number and street, city, state, ZIP code)
/
d Q (�
r - ASSESSOR USE ON Y,gf`
TRUEUETAXt=ASSESSED`�VALUE
�YALUE'cnw�.�`
HOMESTEAD -'`
..- tNONvRES1DENTIAL
'% NO
�Tt100%OF�IlV�
- �:VALUE�
t'..- E.3�..VALUEra•::�`
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)`~
PP. tA�
Total land (line 1 plus line 2)
(3)
Dwelling
(4)b�..
4 yrvr_�
a�.
Residential Improvements or Annually
,
Assessed Mobile / Manufactured Homo
Garage
5
' MINN.*
Other improvements
(6)+,,.-
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(B)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
^-zt� u' ? �.'P C .rSTANUARD.DEDUCTION'gLLOWAMCE
20_ Pay 20_
Lesser of 112 Homestead
u ton or S35. S
Signature of Auditor Daatt�e'"gned _��