HomeMy WebLinkAboutHomestead_Dodde f CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
s. x State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
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/i/1A.. M/ . V- I I Ili aA_eh . r`- � certify �l1�s1�a71'�ay, /4�.579 -1 -J-
our principal place of reside ce the following described real property for which a Homestead Property AVJt9PeV�p by daimeb
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 OWNED BY CLAIMANT IN OTHER COUNTIES
County — Township County Township
1
�'eby certify the above statements are true, correct and complete.
Sign ture of claimant
r
Address (number and street ciry� state, ZIP code)
ASSESSOR USE ONLY
PROPERTY DESCRIPTION
County
Township i
NON - RESIDENTIAL -
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improve ents.
Taxing • ict( n, township)
Parcellnumber
Legal descnp ion
f
YO
` ��
(2)
If any portion of the residential structure or the land not exceeding one (1)
alle that i mediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
(3)
1(
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County — Township County Township
1
�'eby certify the above statements are true, correct and complete.
Sign ture of claimant
r
Address (number and street ciry� 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 improve ents.
(1)
Valuation or $2,000
Signature of Auditor
Otherland
(2)
3_
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)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
dying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 —Pay 19_
Lesser of 112 Homestead
5
Valuation or $2,000
Signature of Auditor
Date signed
9
3_