HomeMy WebLinkAboutHomestead_HoffmanCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (R817 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
�E RM YEAR
H 10
AUG 0 7 '1003
I (We) `u :7 1, 7� -Q/► —� certitj"nt WQhlt"i'9a� NF 20
I (We) occupied as o r principal place of res" nc the following described real property for which a Homestead Property Tax Credit is hereby claimed:
n I (We) owned 0 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.
Paul number Leg q1 descripti on I Is the property in question:
vy� L G I �-/�. �—I ❑ Real rly ❑ Mobile Home (IC 6-1.1 -7)
If 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 inmme.
(number and street, city state. and ZIP code)
pay 20_
Lesser of 112
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
signed (month,
Land not exceeding 1 (one) aae immediately
surrounding residential improvements.
-.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
;,•. -: . ':':
Assessed Mobile I Manufactured Home
-
Garage
(5)
-
Other improvements
(6)
Total improvements (lime 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby cer ify the above is true, correct, and
Signature of Assessor
Date signed (month, day. year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. year)
pay 20_
Lesser of 112
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
signed (month,