HomeMy WebLinkAboutHomestead_Krieg (2)ry� . CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
y State Form 5473 (R418 -00)
u.
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) r certify that on the 1st
I (We) occupied as our principal pia o residence the following described real property for w ch Homestead Property Tax Credit is
❑ I (We) owned ❑ Are buying under contract
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prope _ . _ uyug,u
GONTRACT ±RECORDED• +`tr'+#ip'.
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded - - Record number Page
GL--IM_A'Nl'
�.:Y�"1- ':n3;5m< -
_. +J- PROPER_T}YES'- CRIPiT <'_.1 -_'" x.�_= ,- >.3°t?� "Qis'
Em
County
I hereby certify the above statements are true, correct and complete.
Township Taring H}; town hip)
Par nu
ben
Legal d n
I n n of the residential structure or the land not exceeding one (1) Pare that immediately . surrounds that strut used to produce income, describe the use and portion
of the property utilized to produce income
GL--IM_A'Nl'
IN
County - Township
County Township
I hereby certify the above statements are true, correct and complete.
S' to
ai ant
1�n s
(number and street, cily, state, ZIP code)
AV
p"�r'�' "- Y ",.� `- -..',+
y�{{��,,ASSESSORUSE ONLY.
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+" RUE' -TAX "^4
jASSESSE VD6' _,4_LTUEFIOMESTEADNON=
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t-
y RESIDENT AL
's "�.-'. ° ',i Rs'.
ut �r t i:`u�.:'��'T10..
1�n s
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Signat I itor
Date si�op�d) %
l./ lL7
-
Land not exceeding 1 (one) acre immediately
- -' -
surrounding residential improvements-
i1)
W "
Other land
(2)
Tidal land (fine 1 plus line 2)
(3)
Dwelling
(4)
'sr -"'�`'`
Residential improvements
Garage
,�j'.� } ..,.
()�-
,tea
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 p1m line 7)
(6)
I hereby certify the above is We, correct, and
Signature ofAssessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
DEDUCTIONI LLOWANCE
20 _ Pay 20
Lesser of 12 Homestead
$
Valuati o or $6,000
,
Signat I itor
Date si�op�d) %
l./ lL7
I
9