HomeMy WebLinkAboutHomestead_Flahertyi CLAIM FOR HOMESTEAD PROPERTY TAX FIO
; CREDIT /STANDARD DEDUCTION nn�� a -l� Hao
• State Form 5473 (R2 15-92)
MAY 01995
INSTRUCTIONS: See reverse side for filing instructions.
YEAR
I (We) -h _U�f - certify that on the 1st day of March. 19
I (We) occupied as our pri c al ce of residence th Ilowing described real property fp hich a Homestead Property Tax Credit is hereby claimed:
fl(We)owned El 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 (city, town, township)
Parcel number �]
oo0
Legal description
If any portion of the r .dential structure or the land not exceeding one (1) acre that immediat urrounds that soucture is used to produce income, describe the use and portion
of the property utilized to produce income.
ifPROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County I Township I County I Township
certify the above statements are true, correct and complete. igna re claimant
(number and street, city, state. ZIP code) ` c
ASSESSOR USE ONLY _
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(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
Verifying action - Signature of Auditor
ANk
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2.000
S
Signature of Auditor
Dates nad