HomeMy WebLinkAboutHomestead_Marshall (4)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
� State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
/j_ CERTIFICATION STATEMENT q Wig; -q,7 3�;• „-�.�
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(We) rtify aC. O 1st day of March, 19_
I (We) occupied as our principal plac residence the following described real property for which a Hogsteld rPry6b Tax Credit is hereby claimed:
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Zj I (We) owned El Are buying under contract lJ
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property an at owns the prop —irty or is buyi under a contract.
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CONTRACT RECORDED” -� •,: r''�• =�T•• : •r:_rf3Q�i
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPWN
coon
Township
Taxing d , t ship)
/iict
Parce number
Legal descripG
0 -� C
- .
If any portion of the residential structure or the land not ex ding one () a e that immediately, surrounds that structure is used to produce income, describe the use and portion of
the property uttilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County Township
County Township
ereby certify the above statements are true, correct and complete.
Si f claimant
Ad umber and street, dry, state IP codel /�
ASSESSOR U E ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land
(2)
Total land (line I 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)
I hereby certify the above is true, Correct, and
Signature of Assesor
Date signed
complete.
Vedlyfng action - Signature of Auditor Date signed
.� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or 52,000
Sign a Audito
Date si n