HomeMy WebLinkAboutHomestead_Briggse� g CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
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Slate Form 5.473 (R2 15-92)
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INSTRUCTIONS: See reverse side for Wind instructions.
FORM YEAR
HC10
1 �
CERTIFIC N STATEMENT (, ; . j -
contract / / P,
El Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the g0rty ocvs b yiitgundeh:�e'ebnGtracl.
- - CONTRACT RECORDED',
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DE
IPTION
County
- - -
Co
Signatur f claimant
Valuation or $2,000
Township
Toxin
istdct (city, own, township)
P cel nu ber
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eg I ription /'�
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It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used top
of the property utilized to produce income.
uce income, tles
ibe Meuse and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
® +by certify the above statements are true, correct and complete.
Signatur f claimant
Valuation or $2,000
x �
Address number a4 street, cl state, code)
Other land
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ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE.
HOMESTEAD
VALUE
NON- RESIDENTIAL.
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
S
Other land
(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 pbs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
$
Valuation or $2,000
S
n lure of ua r
Date sign4,dl