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
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