HomeMy WebLinkAboutHomestead_BrownCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/5-92)
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INSTRUCTIONS: See reverse side for filing instructions.
STATEMENT
F M• YEAR
,APR 2 G 1995 l/
e) _ certify that on the 1 slifa!�Ht MafEh, 19
`)occupied as our princip I place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
l(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 owns the property or is buying under a contract.
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded _ — -- r, n I Record number� ,,.,I Page -7
' - PROPERTY DESCRIPTION
County
Township
Taxing district (ci ,fawn, township)
Can
Parcel number
Legal description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
County
Township
County
Township
�eby certify the above statements are true, correct and complete.
Sig natur t cl �i ma
6_LJt,L
Address (number and street, city, state. ZI code)
Other land
D L b 1,J 2Sf
I v
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE,
HOMESTEAD
VALUE
NON -RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 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
rr�.itying action - Signature of Auditor
Date signed
19 _Pay 19_
Lesser of 1/2 Homestead
Valuation or $2.000
. STANDARD DEDUCTION ALLOWANCE
Date signed