HomeMy WebLinkAboutHomestead_Blemker0 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (R817 -07)
Prescribed
by the Department of Loral Government Finance - {�
INSTRUCTIONS: See reverse side for filing instaicfions. - \I\ JUN 3 - 2009
I (`"e) `w certify —
I (We) oocup(ed as our princi place of Idence the following described real property for which a Homestead Property Tax Credit is hereby claimed
I (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 •'. .
I buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
County
Township
I hereby certify the above statements are true, correct and complete.
of claimant
res (number ant,�reet, ot7: state. and ZIPcods)
OS /1 ✓S f ICQc�C �c C
ASSESSOR USE ONLY
TRUE TAX.VALUE
ASSESSED VALUE!:
HOMESTEAD
PROPERTY DESCRIPTION
AT 100% OF TTV
Township
lacin i
' (c Y. townsh' I
�/'��
I
n
Pamel number
L al scdpti� I
Is the property' uesticn:
Real property obile Home (IC 6- 1.1 -7)
If arty n of the residential structure or the IoM not exceeding one (1) acre that un that re is used to produce Income, describe the use and portion
of a rty utilized N produce income. l
�(
7RW
a� Cl_ J_ )A _boo. /(),;l7-_ 00
Total land (line 1 plus line 2)
County
Township
I hereby certify the above statements are true, correct and complete.
of claimant
res (number ant,�reet, ot7: state. and ZIPcods)
OS /1 ✓S f ICQc�C �c C
ASSESSOR USE ONLY
TRUE TAX.VALUE
ASSESSED VALUE!:
HOMESTEAD
NON-RESIDENTIAL
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
-
- "" •'i +-':: '(+' - _
'
Assessed Mobile I Manufactured Home
Garage
( 5 )
_ .
Other improvements
(8)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor -
Date signed (month, day, year)
complete.
Verifying action - Signature of motor
Date signed (month, day. yW
20_pay 20_
Lesser of 12
Homestead Valuation
or
Signature of /uxitor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (month, day. year)