Homestead_SandifarVA
CLAIM FOR HOMESTEAD PROPERTY TAX
a/
} CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
certify that on the 1 st day of March. 19
I (We) occupied as our principal place of resid1¢ncEljlllr�iq ldescribed real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying undei ,^
❑ Have a beneficial interest in the entity that is l the property taxes on the property and that owns the property or is buying 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 DESCRIPTION
County
Township
Taxing district (city, town, township) -
Parcel number
O
Legal description
If any portion of the residential structure or the land not exceeding on (1) acre that immediately surr u ds 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
I_County
Township
County
Township
hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street. city. state, ZIP Code)
/%k(aAd CA. Z/l/q ?G�d
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 Auditor
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)
(6)
I hereby certify the above is true, correct, and
mplete.
Signature of Assessor
Date signed
,tying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
, n I
Date sigied — O