HomeMy WebLinkAboutHomestead_HillmanCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
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CREDIT /STANDARD DEDUCTION HC10 i99a
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT -
1 (We) 1�•, certify.that on the 1 st day of March , 19 9a
I (We) occupied as our principal place of residence the
, ffoollowing described real property for which a Homestead
Property Tax Credit is hereby claimed: . L"J I (We) owned ❑ tract
Have a beneficial interest in the entity that. is liable for the property taxes on the Vpe =y'Dsthe
❑ - property or is buying it under a contract.
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CONTRACT RECORDED
It buying on contract. Fee Simple Owner's Name AUp�TOR
Recorder's office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
Coun Township Taxing District City, town, township)
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0 /c�l Number 5a % Legal Description
If any portion of the residential structure or the land not ex66eding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
I hereby certify the above statements are true, correct and
state
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
- Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
'
(1)
1991 Pay 1992
19— Pay 19—
Lesser of 1/2 Homestead
(2)
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1.500
Valuation or $1,500
(4)
- - -
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19— Pay 19—
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2.000
Valuation or $1.500
Valuation or $1,500
Signature of Auditor
CN�►r�rce� Z 5
Date Signed
I ,/— /o— 9aZ
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