Homestead_FrederickCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION .
State. Form 5473 (R2 15-92)
s INSTRUCTIONS: See reverse side for filing instructions.
F I, YEAR
f
jF
R R L
//,� N 17 1999
K '/a /1 a
CERTIFICATION STATEMENT n;.,..... —4-41V
1 (We) that on the 1 st day of March, 19_
I (We) occupied as our principal place of residenc6 the following described real prope ead Property Tax Credit is hereby claimed:
❑ 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
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (ry town, township
Parcel number
Legal description
R�4 –
It any portion of the residential structure or the land not exceeding one (1) acre that immediately 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 COUNTRIES
County
Township
County
Township
_reby certify the above statements are true, correct and complete.
Sig lur f claima
q au Maki
Address (number aqd street, city, state. ZIP Code) nIp /^
1 v ��W O
ASSESSOR US NLY
TRUETAX
A6ESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead 5
Valuation or $2,000
Signature of Auditor -
Date signed