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HomeMy WebLinkAboutHomestead_Maikranz (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION HC10 Stale Form 5473 IRS / 4-03) Prescribed by the Department of Loral Government Finance INSTRUCTIONS: See reverse side for filing instructions. -9 I (VJe) J certify tfiaCon the.l so t March, 20_ (We) occ pied as our principal plat.: of residence the following describe re property for which a Homestead Property Tax Credit is hereby claimed: 1 (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 ownEt:yr6p`erty or is b ng— undei a contract. CONTRACTRE_CORDED' If buying on contract, Fee Simple owners name Recorders office where contract is recorded Record number Page :MEst� ; ���i��sPROP .ERTY;OWNEDjBY:CL'AIMA NT; IN ( OTHER "COUNTIES ftteZ- �'e,rYs - ...� - .- at�viP, ROPERTY. DESCRIPTfON County Township Signature of claimant ' Taring district (city, town, township) 0 P cel umber L a d do rr�� the property in question: _ Qf 1 ❑Real property ❑ Mobile Homo (I.C. 61.1 -7) If any portion of the residential structure or the land not exceedin a (1) alre that immbiliatety wnounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. :MEst� ; ���i��sPROP .ERTY;OWNEDjBY:CL'AIMA NT; IN ( OTHER "COUNTIES ftteZ- �'e,rYs County Township County Township hereby certify the above statements are true, correct and complete. Signature of claimant ' �d ands !, rify,�tate, Zl e) LA L L in CI ESSOR USE ONLY =-- IKUM -,I h Lfrii? ,3 ASSESSED VALUE ^ HOMESTEAO��`' P. NON- RESIDENTU1L b it.�tvVAI:UE� 0 FAT,�700 %OFii!!V- 3uVALUE;s i.#agVAI.UE�.?:.StGG'.? Land not exceeding 1 (one) tints. atety Date si ned —O_ ve surrounding residential improvements. Other land ,t amitrsr >�.L� Total land (line 1 plus line 2) (3) Dwelling (4).rF',l- Residential improvements or Annually S'..s,,'r'..2: Assessed Mobile /Manufactured Home a Garage (5) .NO ri Other improvements (6) �v Total improvements (line 4 through line 6) (T) Trial value (line 3 plus line 7) (6) 1 hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed --STANp` ARD_. OEDUCTIONiALLOWANCE low 20 _ Pay 20 _ -T Lesser of V2 Homestead 5 Vauation or 535.000 Signature of Auditor Date si ned —O_