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HomeMy WebLinkAboutHomestead_TruittCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION •,I State Form 5473 (112 15-92) - ` INSTRUCTIONS: See reverse side for filing instructions. FORM YEAR HC ADD n 4 9nni CERTIFI ATION STATEMENT • I (We) ertity tha 1 y o c 19_ I (We) occupied a ur principal place of residence t oll ing described real property for which a Home iA� laimed: ❑ I (We) owned ❑ Are buying under contract ❑ 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 owners name Recorders office where contract is recorded Record number Page • PROPERTY DESCRIPTION Cou Z Township Taxing district (city, towcr ship) arcel number -oiaGP7 -DO Legal descrip f w -a- T . 35 If any portion of the residential structure or the land not excee ing one I1) 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 COUNTRIES County Township County Township ereby certify the above statements are true, correct and complete. S nat a of cl ant ddre umber and street, city, state, ZIP code) 1 1 , �• ASSESSOR USE ONLY TRUETAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Otherland (2) Total land (line 1 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 Veritying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 Lesser of 1/2 Homestead Valuation or S2,000 $ - Signa of Auditor Date signgd �/f ^/ I �vr�