HomeMy WebLinkAboutHomestead_Simpsona1 CLAIM FOR HOMESTEAD PROPERTY TAX
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CREDIT /STANDARD DEDUCTION
State Form 573 (R2 15-92)
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INSTRUCTIONS: See reverse side for filing instructions.
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MAY 10 1993
I CERTIFICATION STATEMENT . /J__ -_ , Al 124, 1-1 1
AUDITOR g
certify that on the 1st day of March, 19
t .) occupied as our principal residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
Eā,!\(We) owned ā Are buying under contract -
ā 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 under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
' PROPERTY DESCRIPTION
County
9660
Township
Taxing district (City. 1 . township)
/V
_reby certify the above statements are true, correct and complete.
Signature of claimant
Parcel number
Legal d iption
016 - 40/009ā o v
Land not exceeding 1 (one) acre immediately
If 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
_reby certify the above statements are true, correct and complete.
Signature of claimant
VALUE
X S
Address (number and sbeeL city. state. ZIP code)
Land not exceeding 1 (one) acre immediately
S -
Ile,o
rM
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
-
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2))
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(8)
1 hereby certify the above is true, correct. and
Signature of Assessor
Date signed
complete.
.yirg action nature of Auditor
I1 .
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
STANDARD
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Date