HomeMy WebLinkAboutHomestead_MeiringCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDMSTANDARD DEDUCTION HCto
State Form 5473 (8715 -06)
Preambed by the Departnent of Leal Goveffunerd F�
INSTRUCTIONS: See reverse side for Ring instructions, I -P T)
Y 1 7
1 (We) " certify that on the A1 st day of ag. 20_
I (We) occupied as ouLancipal place of residence the following described real property for which Olornestead Property, Tax Credit is hereby claimed:
M— W I (We) owned ❑ Are buying under aoritrect Alzll- lelor--
67 6r
eve a benefidal interest in the entity that is liable for the property taxes on the property and that owns the ;x6p"(aHsW44W&HAA?9Q&ct
'V-4�w. to C ONTRACT, REC ORD ED
H buywig on oontract, Fais Sunple owners name
Recorders offios where Contract w receded Record number Page
I ... , - -111
11 :.. -11,11,11111, - I '�— r. : " X-,0FCdPERT.Y,DESCRlP.Tl6-.
Canty
To h . p
County
.. .
7109m districk(city, town. township)
I tfjaz-le� efz�-
Parcel number
egal demmptiod,
-
Is the prop" In queston:
1
I
Otherland
� 1-3
13R=Wr [1 Mobile Home (fc.a-i.i-7)
If e portion of the residential structure or the larxd not exceeding one (1) aife
that immediately surrounds that SULKWM is used to produce in=ne, describe the use and portion
of a property utilized to produce in ne.
(3)
)-& - / cj -100 - / ol -.00 0,
't. ' PROPERTYOWNEDIBYXWMANTIN MMV WWrYy,,Z-V
r? ,fO
0THER-,d0UNTlESW,0)
County
I Township
I Comfy Township
I hereby certify the above statements are true, correct and complete.
Si of dairnant
stravd.
Otherland
(2)
Sgnatue of Auditor
W"
(3)
011
ASSESSED VALU E
HON-EYST.-EANC
� VALUE �9*
.�
0.
0'W9VrV
Land not exceeding 1 (one) acre imaxadialely
suntrundirV residential improvements.
Otherland
(2)
Sgnatue of Auditor
Total Land (16ne I plus line 2)
(3)
Residential improvements or Annually
Assessed Motile I Manufactured Home
Dwelling
(4)
VM�MRMZZ'- )'C'
WEA e- 1,0112XV0
Garage
(5)
Other improvements
(6)
TctEd improvements (Jane 4 through fine 6)
(7)
Total value (line 3 pits One 7)
(8)
I hereby certify The above is true. carted, and
complete.
Signature of Assessor
Date signed
Vatlying action - signature at Auditor
Date signed
STANDARD DE0UCTl0N!ALL0WANGE-.,-'
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or 535.000
Sgnatue of Auditor
Data signed