HomeMy WebLinkAboutHomestead_RhotonCLAIM;FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
�1 State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS., See reverse side for Ming instnuctions.
FORM
YEAR
I (we) — If i I lyy\ Q 3L) IN, 1 � r-� �/ — _ _ _ certify that on the tat day of March. 20_
1 (We) occupied as our rincipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
Or— I (We) owned ❑ Are buying under contract
ave a beneficial in rest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
-G�CONTRACT-RECORDEDf--',�:'-C� -.--!*- -�i -
If buying on contract. Fee Simple owners name
Recorder's office where contract is recorded Record number Page
J -PROIPERTY.DESCRIPTIOW,�-
County
Township
Twvnship
Taxing M%d (cif)4 ,township)
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Signature of claimant
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Parcel number
I description
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Is the property in question:
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I ❑ Real property ❑ Mobile Home (I.C. 64.1-7)
If any portion of the residential structure or the land not exceeding we (1) am that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
surrounding residential Improvements.
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Q STANDARD DEDUCTION "ALLOWANCEirk.
County Township
County
Twvnship
1 hereby certify the above statements are true, correct and complete.
Signature of claimant
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Q STANDARD DEDUCTION "ALLOWANCEirk.
20 _ Pay 20 _
ASSESSED VALUE
Lesser of 1/2 Homestead
RESIDENTIAL -`,:
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Land not exceeding I (one) acre immediately
surrounding residential Improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Residential Improvements or Annualty
Dwelling
(4)
Assessed Mobile I Manufactured Home
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Garage
(5)
C �Ifer improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(a)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
Q STANDARD DEDUCTION "ALLOWANCEirk.
20 _ Pay 20 _
Lesser of 1/2 Homestead
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Valuation or 535,000
Signature of Auditor
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