Homestead_Gonzales (2)CLAIM FOR HOMESTEAD PROPERTY TAX
} CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
yu
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
.. .. "CERTIFICATION STATEMENT--
I (We) _ _ - o e 1 - -or "hah, 19
I (We) occupied as our princip lace of residence the folio , described real property for which a Homest Pry claimed:
r-r] I (We) owned ❑ Are buying under contract r1 Lapp
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the C gAea & iJWg under a contract.
. . CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorders office where contract is recorded I Record number Page
' PROPERTY DESCRIPTION
County
Township
Taxing district (dry, town, township)
Parcel n tuber
Lega to escription
igned�
It any portion of the residential structure or the land not exceeding one ( ) acre that immediately surrounds that structure 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.
igned�
.
Otherland
(2)
Total land (line 1 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
Date signed
- STANDARD DEDUCTION ALLOWANCE" -
19_ Pay 19_
Lesser of 112 Homestead
$
Valuation or $2,000
Signature of Auditor
Dat
igned�
If