HomeMy WebLinkAboutHomestead_Cochren (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
" �I)C10
�.A j
25 1995
I CERTIFICATION STATEMENT - I
WiLl l Nom- _I_s/ U 1A< 2 r (kwn ry Lryr / Abce yityOR on the t st day of March, 19
occupied �(" our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
u 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 owns the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION _
County
Township
Taxing district (oily, town, township)
Parcel number
I/
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 5rodum 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.
S net ire of ant
Address (number and street, city, state. 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)
Valuation or $2,000
Signature of Auditor
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(6)
_
Other improvements
(6)
Total improvements (line 4 through line b)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
rityirg action Signature of Auditor
Dare signed
- STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor
Date i n -
lo!