HomeMy WebLinkAboutHomestead_NelsonCLAIM FOR HOMESTEAD PROPERTY TAX FORM AR
CREDIT /STANDARD DEDUCTION HC10
.;, State Form 5473 (R2 15-92)
Aso
INSTRUCTIONS: See reverse side for filing instructions.
�I '—Ve) _ ,_r Kl y 7 certify 1ha9 lhJl jd,4 r ,A
occupied as , principal place of rest ence the following described real property for which a Homestead Propert redit s hereb claimed,
owned ❑ Are buying under contract -
1999
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the proM or is buV. under a contract.
- CONTRACT_ RECORDED
It buying on contract, Fee Simple owner's name - - -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTI
County
Township
Taxing dist (c for . w hi ' -
el ber
:no?( 1 -00
Legal description
If any portion of the residential structure or the land not exceeding one (t l 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
eby certify the above statements are true, correct and complete.
Address (number and street, city. state. ZIP code)
of claimant
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
Signature of Audi- t
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)
(g)
1 hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
Vr Mng action - Signature of Auditor
a
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Audi- t