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HomeMy WebLinkAboutHomestead_Watsonofbrx'b - CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Form 5473 (R2/ 5-92) 1 6 INSTRUCTIONS: See reverse side for filing instructions. FORM HC10 S m2", YEAR ML CERTIFICATION ST MENT To R. Gl c frp�lla `on h4 ffO D %ay of March, 19_ , following described real property for which a K6mestea d Property Tax Crdit is hereb claimed: I (We) occupied as our principal plac of residence t ❑ I (We) owned ❑ Are buying under contract ❑ Have a beneficial interest in the enti that is liable for the taxes on the roe and that owns h oris 6u in �fii1`t(er a contract. entity property P P rtY Pr�Y., Y g. a (,IBSOh CJUS? t - CONTRACT RECORDED If buying on contract, Fee Simple owners name ��- 11 . . Recorders office where contract is recorded - - Record number Page —� PROPERTY DESCRIPTION �Oyy County O Taxng distri (dry, t Cwc�shuip. ) bet -DU S r-)- -0 Legal description IT DIT'. 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 COUNTRIES County Township County Township ®ereby certify the above statements are true, correct and complete. Sign re of dairtunt ^ Address (number and street, city, state, ZIP code) 3 A L re I I n L< <¢ o ASSESSOR USE ONLY TRUE TAX 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) I hereby certify the above is true, correct, and complete. Signature of Assesor Date signed Verifying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 esser of 1/2 Homestead alua on or $2,000 $ Signature of Auditor Date si nec FrA