HomeMy WebLinkAboutHomestead_BrommCLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State Form 5473 (R7 I 5-M
Prescribed by the Departnerd of Lo®I Coverrynent Frtaee
INSTRUCTIONS: See reverse side far Ming instructions.
mm
FORM
I (we) Y�A A N4-.J/ t " r r I o r j — ce" that on the I st day of March, ZD —
I (We) ;;;� as our prinaTpid p;�a�w tresidence the following described real property for which a HorneA&66 edit is hereby claimed:
P _p"Z Fr
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 cpwns'afteW"�buying under a contract.
CONTRACT,RECOROED!"�
if buying on contract, Fee Surple owners narre
RemrdaS ollice whee contractiarvaii Record number Page
1A
PROPERTY 0 ESCRIFnON+ :'
X"I
rtkacv-
Township
1
Township
Timing district
I
I
.
VALUE' a
rcel
Legal desorption
—
Is the WoR"i
question:
T- -30 00 0
a=
_!
W±!� property (LC &l.1.7)
If any portion of the reaKlential stuck" or the LaW nol exoeadng one
(1) eoe that irnmediaisty airnounds M itmEture
is used to produme inserts, describe the ui;e and portion
of the property Wi(®d to prod" irrmre.
..... .'pRoPERTY owmm BY, CLAmmT, [Womet COUKT1ES;f6-`
TRUE TAX
County
Township
county
Township
I hereby certify the above stalernertts are true, correct and cornplete-
VALUE' a
id
0 7b) m .'y .7
(5,7,it-A
Ah
LAI b
,,STANDARD DEDUCTION ALLOWANCE
TRUE TAX
ASSESSED VALUE
"`H'0"A1E'STE-A'D-
NON
;%,ASSESSOR USE ONLY N
Mlib W J
VALUE' a
Land not exceeding I (one) acre ininiedialiely
q
surrounding residential improverrients-
Other land
(2)
Toted land (Ikm I plus line 2)
(3)
Dwelling
(4)
Sy,
Resdenfialffnprovenentso Annually
m
Assessed Mobile If ManzdacturBd Home
Garage
fJ��
(5)
3M
Other tinprovernents
(6)
Total unproverrients (fine 4 through Erie 6)
(T)
Total value (We 3 plus fine 7)
(8)
1 hereby certify the above is true, coffecL and
ompiete.
signature of Aimimmitor
Date signed
Van" action- Signtitune GfAwktor
mis signor
,,STANDARD DEDUCTION ALLOWANCE
20— Pay 20—
Lesser of 112 Homestead
Valuation or MODD
STI
Mlib W J