HomeMy WebLinkAboutHomestead_Boedekerea'J CLAIM FOR HOMESTEAD PROPERTY TAX
d. CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
CERTIFICATION STATEMENT"' -' �.° •� - -
I (We) _ certify o h st h,
I (We) occupied as our principal place of residence the following de ri a real property for which a Homestea (Cy 'claimed:
fl 1 (We) owned ❑ Are buying under contract APR Q 1999
ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or Is uying under a contract.
i'
It any portion of the residential structure or the land not exceeding one (1) cte that i edia:ety surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
f claimant
CONTRACT RECORDED. - - Y °AUDITOR.
VALUE
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded
Record number
Page
- PROPERTY DESCRIPTION --
County
Township
Taxing district (city, town. township)
Parcql qumt>ef
Legal description I
It any portion of the residential structure or the land not exceeding one (1) cte that i edia:ety surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
- PROPERTY OWNED BY CLAIMANT.INOTHER COUNTIES -
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Sign r
f claimant
'r (numlleyn tr et, ci ta1 . IP Code) �.
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
'-
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
a
Other land
(2)
t'-�,� `.' •.
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
- -
Residential improvements
Garage
(5)
-
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plis line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
verifying action - Signature of Auditor
Date signed-
•-•
I STANDARD DEDUCTIONALLOWANCE " - --'?,
19_Pay 19_
Lesser of 112 Homestead
$
Valuation or 52,000
Signature of Auditor Date signed