Homestead_Traylere ^x s CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
nIG
INSTRUCTIONS: See reverse side for filing instructions.
115FORM HC10 YEAR
? ' (�
AUG - -_ iggk
1,V e) Y y on the 1st day of March. 19_
occupied as our prin al place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I e) owned ❑ Are buying under contract
❑ Have a beneficiat 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 Township Taxies tlistrict (city. town. township)
Parcel number /!�` Legal description
V
It 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
9eby certify the above statements are true, correct and complete.
ign re of clai ant
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.
I (1)
Signature I;or
Date edu
1
Other land
(2)
Total land (line I plus line 2)
(3)
improvements
Dwelling
(4)
IResidential
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pkjs line 7)
(6)
k1hereby certify the above is true. correct. and
mplete.
Signature of Assessor
Date signed
dying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
Signature I;or
Date edu
1