HomeMy WebLinkAboutHomestead_Brucee% g CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
+..;; State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I - _ .,cn nnt,wtwry alwt cl +)Zryl 1I °:11 -1 f"1 P _ - I
I rWe) 1 - - certify that on the 1st day of March, 19
•:) occupiedtV our principal place of residence the following described real property for �ty�gre r2AMIroperty Tax Credit is hereby claimed:
El (We) owned El Are buying under contract I 1 „
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❑ Have a beneficial interest in the entity that is liable for the property taxes on the p erty and th ow She proae�ItyYr is buying under a contract.
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It buying on contract, Fee Simple owner's name
Record number I Page
�'- PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township) -
Parcel number
% _d
Legal description
If any portion of the residential structure or the land not exceeding one (1) acre that im ediately Burr nds 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.
Sfgnatur of claim t
Address (number and street, city, stare. ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor
'
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
y�9?►
H
(4)
Garage
(5) '
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pUs line 7)
(6)
1 hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
V� ng action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
$
Signature of Auditor
Date s� ed
,�°- a -