HomeMy WebLinkAboutHomestead_ThomasCLAIM FOR HOMESTEAD PROPERTY TAX F YEAR
CREDIT /STANDARD DEDUCTION HC
State Form 5473 (R215.92) -
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INSTRUCTIONS: See reverse side for filing instructions. APR 2 0 199?
- . . . • - CERTIFICATION STATEMENT -
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1 (We) )D K ik m �. Q •���p�Q, f�, certify thAU[(}�I;TIS Qa of March, 19
�) occupi as our ' cipal place of re`siid-9f'ncee tthe follescribed real property for which a Homestead Property Tax Credit is hereby claimed:
❑ f(We)owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the properly 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
Recorders office whey contract is recordetl Record ber Page
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' PROPERTY DESCRIPTION
County
Township
Taxing district,(city,,town, township)
Parcel number
Legal description
If any portion of the residential structure or the land not exceeding one (1) acre that imcfaetely 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.
®
Sign re of claiman t
Address (number and street. city, state. ZIP code)
to me
LIA
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
Otherfand
(2)
Total land (line I plus line Z)
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)
1 hereby certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
Sing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE -
19_ Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed
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