HomeMy WebLinkAboutHomestead_DaltryCLAIM FOR HOMESTEAD PROPERTY TAX
FORM:- �; YEAR
x� CREDIT /STANDARD DEDUCTION HC10 Y.
State Form 5473 (R2 / 5 -92
SAY ] Q
INSTRUCTIONS: See reverse side for filing instructions. 1994
I'We) _ - certify that on the Isl day of March, 19
aoccupied as our principal place of residence the foil U ling described real property for which 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.
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 (ary, town, township) - -
Parcel number
-bl)(075-00
Legal description
S
If any portion of the residential structure or the land not exceeding one (1) acre that immedi , iy 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 _ J
County Township I County ITownship
certify the above statements are true, correct and complete.
Address (number and street, ary. state. ZIP code)
M—
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
1
Other land
(2)
Total land (line I 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 plus line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
yprifying action - Signature of Auditor
Date signed
- STANDARD DEDUCTION ALLOWANCE
19 Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2.000
Signature of Auditor
Date signed' _ ^�