HomeMy WebLinkAboutHomestead_BartlettCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
° State Form 5473 (R215-92)
INSTRUCTIONS: See reverse side for filing instructions.
FRF M YEAR
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DEC 0 6 1999
CERTIFICATION STATEMENT
I (We)
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I(pppWe) occupied as our principal place of residence the following
described real property for vklh a Homestead Property Tax Credit is hereby claimed:
(We) owned ❑ Are buying under contract
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
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, towns ip)
IS
Parcel number
Legal description
If any portion of the residential StmIXUre 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 utiI¢ed to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
Signatu of claimant
Hereby certify the above statements are true, correct
and complete.
-
Address (number and street, city, state, ZIP code)
D
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
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 Assesor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
D++�..�
Dat e signed _