HomeMy WebLinkAboutHomestead_KriegCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/5-92)
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FORM YEAR
HC10
INS I HUG I IUNS': See reverse Sloe for filing Instructions.
1
CERTIFICATI N STA E NT
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I (We)
certify thatrdfi'1he istl)Wamh, 19
1 (We) occupied as our pdncip I lace of residence the following de ibed real property for which omestead hereby
❑ I (We) owned ❑ 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 properllCdi I�bllyingylrcfepm�ntract.
CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Tatting distric ty, wn
Ship)
ParceQ 1-00765 �
Legal dew lion
It any portion of the residential structure or the land not exceeding one (1) acre that immediate s nountls N stnrctu a used to produce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
Signature imam
ereby certify the above statements are true, correct and complete.
'
Address (number and street, city, state, ZIP code)
t
7
ASSESSOR USE ONLY
TRUE TAX
A SESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
Verifying action - Signature of Auditor
Date signetl
® STANDARD DEDUCTION ALLOWANCE
Pay 19
Lesser of 1/2 Homestead $
Isi19_
Valuation or $2,000
nalu a Auditor
Dat signed
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