HomeMy WebLinkAboutHomestead_BoostCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
rug
INSTRUCTIONS: See reverse side for filing instructions.
occupied as our principal place of residence the following described real property/lor/which a
FORM YEAR
HC10
of March, 19
Vbereby claimed:
❑ I (We) owned ❑ Are buying under contract V x . L A. —"
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns tl &pe' a)r tq7in under a contract.
CONTRACT RECORDED - n n
If buying on contract, Fee Simple owner's name G!RSON OU . Y q
UDROR
Recorder's office where contract is recorded - Record number Page '
s`
PROPERTY DESCRIPTION
County
Township
•gby certify the above statements are true, correct and complete. Signature of claimant
Taxing district (city, town, township)
Parcel number
21
Legal description
4116-
It any poh on of the residential structure or the land not exceeUmq
of the property utilized to produce income.
one (1) acre that immedia urrounds that structure is used to produce income, describe the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township County
Township
•gby certify the above statements are true, correct and complete. Signature of claimant
Address (number and street, city. state, ZIP code)
f2 L
ASSESSOR USE ONLY
TRUE TAX
VALUE
SSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL _
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(t)
Signature of Auditor
Date si ed
1
Otherland
(2)
Total land (line I plus line 2))
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plrs line 7)
(6)
I hereby certify the above is true. Correct, and
complete.
Signature of Assessor
Date signed
Van ng action -Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
$
Signature of Auditor
Date si ed
1