HomeMy WebLinkAboutHomestead_HovisCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Nc10
State Form 5173 (R6 / 4-03)
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certify that Al 1st dg Mein, 20
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract 7 -2/9 �.
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the I>_rgpg5plpr0;DUj•5Tg(u VmiE`)sTiRi Vact.
CONTRIiCTsRECORDEDt- ,i.a'';s'z`�. %- %Z, ry^%i+'.ki`^
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If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
P.ERTY:DESCRIP,TION 2.'.
Coun
Township
Township
Taxing district (city, town, fawn 'p)
Parhlr/1uP ber
v / G _ `-' 0V of -W
L esc
n
n
ICL r7 �t
gperty in question:
Real property ❑ Mob6a Homo (I. 1. / -7)
If any portion of the residential structure or the land not exceeding one (1) arse that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Tx?- �- 'ASSESSOR USE ONLY ` t'`T' r' `=S
•, k .1.!? ! +.:> •> _ -
TRUE TAXI
VALUE . -€�,.- .
County
Township
County Township
hereby certify the above statements are We, correct and complete.
Sig tur claimant - -
1
ress (number aqtoi treef, city; state, ZIP code) -
JOl! / �/ A Sf/�e�
n
ICL r7 �t
Tx?- �- 'ASSESSOR USE ONLY ` t'`T' r' `=S
•, k .1.!? ! +.:> •> _ -
TRUE TAXI
VALUE . -€�,.- .
ASSESSED VALUE
"AT 100%70FTTV�
HOMESTEAD
.VALUE
"` ANON RESIDENTU\ N
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
fir! ra
(2)
Trial land (line 1 plus line 2)
(3)
Dwelling
(4)
as''d" Xw °,tom_
-
I l'�iz:`:Rti�*%6:'
(Residential improvements or Annually
-
Assessed Motile / Man ffacturad Home
Garage
eenn-. r.
s:- t3a.�.v°�_ raz•'".�`- � .ryy a. 1 .�
Other improvements
(6)
�3
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(6)
I hereby certify the above is true, coned, and
Signature or Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20_Pay 20_
Lesser of 112 Homestead
valuation or 535.000
Dat$5 -O ^ -U.6