HomeMy WebLinkAboutHomestead_Mortonsf Rx� CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HCto
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
YEAR
9 i
' "'CERTIFlCATKNi STATEMENT: t ?`,. L
I (We) cert t & g0@0ay of March, 19
1 (We) occupie as r principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
�I (We) owned El Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and th r a contract.
=' CIBSO GO ,Ty Ati. 1. R
CONTRACT•RECORDED
It buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
' -- - - PROPERTY DESCRIPTION
County
Township
Taxing ri (city, w�ownship)
Parcel nu ber
Legal description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER - COUNTIES' - -
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Sgnature of claimant
ress (number and street, aty, state, ZIP code)
�3 "
..I `Fbb 6
- ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD'
VALUE
.NON- RESIDENTIAL ;
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
I
-
-
Otherland
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
-
Other improvements
(6)
-
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plrs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE'- -.
19 _Pay 19_
Lesser of 112 Homestead
FS
Valuation or $2,000
Signature of Auditor
Dare signed