HomeMy WebLinkAboutHomestead_Powell (2)s�` "" CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
• State Form 5473 (R2 15-92)
.•d
6
INSTRUCTIONS: See reverse side for filing instructions.
FORM PEAR
HC10
ERTIF ATION STATEMENT -
I
I (We) l certify that on the 1 st day of March, 19
I (We) occupied as our principal place of residence the following described real properi for which a Homestead Property Ta Cr is hee cl r ed:
❑ I (We) owned ❑ Are buying under contract ar"`.' �._"'`
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property o7 i§ buying under9'contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
P I
be
a3
Legal descnpflon
If any portion of the residential structure or the land not exceeding one (1) acre that immediatety, surrouind6hat structure is used to produce mcolife, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
10-ereby certify the above statements are true, correct and complete.
Signs re of daimant
�-
Address (number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
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 plus line 7)
(8)
1 hereby certify the above is true, Correct, and
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valuation or S2,000
S
Signature of Auditor
7 signed