HomeMy WebLinkAboutHomestead_MarshallCLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT/STANDARD DEDUCTION Ficio
State Form 5473 (R614-03)
Prescribed by the Department of LOCed Government Finance
INS TRUC TIONSi See reverse side for riling hishirclions.
R . ATION STATE
I (we) certify "a;nhe 'Side 20_
principal r g described I (We) occupied as our p Tla! of r i Ace ollowin �crbecl real �property for which �,radP,op(ety�--Tx<C-,re�diity,i:fhM,:bcyh claimed:
❑ buying '18SON C 0
ymg or cent act
I (We) owned ❑ Are buying er cent act Alj'�jj-Cp
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.
TIRECORDED . . . . . .
If buying on ixintract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
far
MW -�iWibli!-ERTY.DESCRIIPTION
County
Township
Township
Taxing district (city, to
r m—occ&a)-
L flon I the pro ny estion:
,=dress (number and sb��Wcify state,110ccide)
eal property ❑ Mobile Hcrno(I.C. - )
If any Portion of the residential structure or the nd not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of theylperty utifted to produce income.
TRUE TAX IffASSESSEDNALUE
T
`AT`100%01F.7VA
R�Wt � . - 6WNE6B,� c&9ANT-I46THEkJd6ffNTIEEe
%nWWFW --P WHE RTY,
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
i natu of elaimaV
,=dress (number and sb��Wcify state,110ccide)
V
'e rASSESWR USIE'614LY" u
TRUE TAX IffASSESSEDNALUE
T
`AT`100%01F.7VA
4H6Mt§TEAD
I-VAt
NOWR9'ffiE-i�T-1ZN f'
-�Mg!
'ZO
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
&- s-
'�-��NWNAINSS
Total land (line I plus line 2)
(3)
Dwelling
(4)
N. WRO
tResidential improvements or Annually
Assessed Mobile Manufactured Home
Garage
(5)
Other improvements
(6)
-
S
IS
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete. I
Verifying action - Signature of A"ditor
Date signed
20 _ Pay 20 TS
Lesser of 112 Homestead
Valuation or 535.000
Sgnature of rib 'r Dat
P-j d N