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
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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
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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