HomeMy WebLinkAboutHomestead_Hughesn CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (F12/ 5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM' T �. AR
HC10
MAY 81996
CERTIFICATION STATEMENT
I 'We) _ _ 4J Y _ - ify that on the 1st day of March, 19_
®,) occupied as our principal place of residence the following described real property for wh(.hk Homestead Property Tax Credit is hereby claimed:
❑ l(We)owned ❑ Are buying under contract _ r
❑ 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
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
P31 number
Legal description
f V�
O
Address (number and street. city, state. ZIP code)
If any portion of the residential structure or the land not exceeding one (1) acre that imm iatety 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 COUNTIES
County
Township
County
Township
®eby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street. city, state. ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I 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
�fying action - Signature of Auditor
Date signed
19 _Pay 19_
Lesser of 112 Homestead
Valuation or 52,000
Signature
S
ALLOWANCE