HomeMy WebLinkAboutHomestead_Cox (2),y"�•4 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HC10
' State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions. Y JM
CERTIFICATION STATEMENT VT 9 i
(We certify that on the 1y2){N)9(;h , -19
I (We) occupied as our prinElpal place of residence the following described real property for which �aa Homestead
Property Tax Credit is hereby claimed: I (We) owned C�}YA I� v" 6r 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 b'ilying it under a contract-
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
- PROPERTY DESCRIPTION
County Township Toxin trio y, town, tow hi
Parcel Number Legal Description
D- NZe / f 2 -8 3S ¢�,.
If any portion of the residential structure or the land n t exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
ASSESSOR USE ONLY - TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling -
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
'
(1)
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1,500
19 — Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
(2)
Signature of uditor
GU
(3)
(4)
-
-
(5)
(6)
(7)
(8)
I hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
Lesser of 112 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 112 Homestead
Valuation or $2,000
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1,500
19 — Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
Signature of uditor
GU
Date Signed
L�— J_ 5�_ —�l�
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