HomeMy WebLinkAboutHomestead_MorrisonCLAWFOR-HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION -
V State Farm 5473 IRS 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM
I (We) � * h I n , b � Ca_&kjk-fy that on the 1st day of March. 20_
1 (We) 4imr �!! 1p"Iace of residence the following diribed real property for which a Homestead Property Tax Credit is hereby claimed:
�a�,,(Wi contract
) owned ❑ Are buying under cont
ave 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-RECORDEDY" -
If buying on contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
r;'-1,= PkOPERT,y,DESCRIRTION6--�.�.�,;�-
County
Towship
Taring dis
I
to l, wnhip)
Z
Parcel number
00
l descnIotion
is the props question:
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perry ❑ Mobile Home (LC. 6-1.1-7)
A�us
If any portion of the residential structure or the land not exceeding we (1) am that Immediately surrounds that s; . t7produce income, describe the use and portion
of the property utilized to produce Income.
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PROPERTY'OWNEb�(3*,'CLAIKi"T-,IN'OTHEFt7COUNIlES"3,4--
County
Township
County
Twvnship
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Jvtss (number and street, cify, state, ZIP code)
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"ASSSSEDYALUE
EOCL6q
HOMEST-;
D.,
-
NONm RESIDENTIAV,-��
Valuation or $35,000
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1AT
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VAL U
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Land not exceedin g I (one) ace immediatey
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surrounding residential Improvements.
Other land
(2)
w- —
&'
Total land (line I plus line 2)
(3)
V V,
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Home
Garage
(5)
improvements
(6)
.9igel
Total Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct. and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
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wr 20 Pay 20_
Lesser of 12 Homestead
Valuation or $35,000
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Signature of Auditor
Date signed