HomeMy WebLinkAboutHomestead_Briggs (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Famn 5473 (R6 / 4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instaclions.
MAR 2 3 2006
I(We) 14 If certiI!ii-ft WILe
I (We) occupied as our principal place of residence the f I ing described r I o erty for which a Homestead Property Tax Credit is hereby claimed
❑ 1 (We) owned ❑ Are buying under contract
1-6 1 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.
If buying on contract. Fee Simple owner's name
—NTRACTRECORDED_;��ik�t
Recorder's office where contract is recorded Record number Page
FROFERWOWNEVBY CaIMANtIWOTAEk*'-66UN;flt§f,�x_'I
County Township
Township
Taxing district (City, town, township)
P a Ou�ber
eg d scription
PLIr9pp rty a3equesbon.
San
,,party Mobile Home (I.C. 61.1 -7)
If MY Portion of the residential structure W the land not exceeding one (1) acre I afrullure is used to produce income. describe the use and porthqf
of theproperty utilized to produce income. h immediately s no - undstha
.j,
FROFERWOWNEVBY CaIMANtIWOTAEk*'-66UN;flt§f,�x_'I
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Sign at a of claimant
Tess (number and street, city, state, ZIP code) - k
n
- 4g�,
_ - USE ONLY
..
-
TRUE TAX
...
ASSESSED VALUE
AT
HOMESTAD
Lk-'IASSESSOR
Land not exceeding I (one) acre immediately
surrounding residential improvements.
San
Other land
.j,
(2)
Total land (line I plus fine 2)
(3)
Dwelling
(4)
'Residential improvements orAnnually
Assessed Mobile I Manufactured Home
Garage
(5)
tip„
Other improvements
(6)
-Z-
-0
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 phis line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STAN10ARDIDEDUCTIOWALLOWANCE
1W 20 _ Pay 20 —
Lesser of 1/2 Homestead
Vaivation or $35.000 $
Signature of Auditor Date signed