Homestead_ParksCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} '= CREDIT /STANDARD DEDUCTION HC10 �7}
ip State Form 5473 (R2 15-9 2)
qu
INSTRUCTIONS: See reverse side for filing instructions.
. ) occupied as our principal place of residence the following described Teal property for which a Homestead Property Tax Cr i dit is hereby claimed.
Li I (We) owned El Are buying under contract ANNE.
. �r �
❑ 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 u can roc .
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 district (city, town, township)
Parcel b r
Legal description / �JJ,;?
a
It any portion of the residential structure or the land not exceeding one (1) re that immediately surrounds that structure is used to produce income, describe the use and portion
of the properly utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true, correct and complete.
Signatur of 'mant
Adrd,r //ess (num e. 2r
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or 52.000
Signature of Auditor
am log
Other land
(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 pkjs line 7)
(g)
I hereby certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
V;! ing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or 52.000
Signature of Auditor
am log
Date signed
/6 0 -9