HomeMy WebLinkAboutHomestead_West;} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
j State Form 5473 (RS / 403)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
- ���� ;' -�„—„ z�c -may- t�•�� -'~. - � '" �/ ?{ CERTIFICATIONSTATEMENTr "r-.'s�
I (We) occupied as our pdripal place of residence the following described real property for which a
❑ I (We) owned ❑ Are buying under contract
FORM YEAR
HC10
Taff Ciedif is hereby
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.
NTRACT;RECORDED' ' _•
If buying on ownract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
s4 + T
91 Mi:ft zw -j. i°.,� �,.'.,fs�,
..„. "fi��a iP,ROFERTY,DESCFiIPTIDN+$?5_� �?.s;:- 1a`rS' `.- °,,. --3 '.s '';..' ,'ti"`a.' .•' ':+;rd
County
Township
Tadng dis t (ci wn, township)
Parcel umber
Legal description
Is the property in question:
11— (00,33 -
1
Real property ❑ Mobile Homo(LC.61.1 -7).
H any portion of the residential structure or the land not exceeding one (1) act that immediately surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income. 4
�:''�.,'?�!� ��' �-rz;?'?�- 4��,EPROP.ERTY, OWNED `:BY'CIAIM{1NTJN'OTHER'COUNTIES c`- �`�;..+- .�'.�2 °- '�'',�S''s:`�'3 Y.e•�'�e"- .'4?1'y�s
County
Township
County Township
hereby certify the above statements are We, correct and complete.
ure of daiman
Address (number and street, city, state, ZIP code)
0
u
h *�tASSESSORUSE ON'Y - 'i §5,
TRUE TAX
ASSESSEDVALUEiHOMESTEN
''ANON= RESIDENTU\L
VALUE ''."AT.�100YaOFTTV�y,{VALUEr-
Nev
Land not exceeding 1 (one) acre immediately
x
w t^ c
surrounding residential improvements.
Otherland
(2)
+` tis' -�
� N
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
''jj,� Z- 4
M4
7c�5 y 4.�+��k.?d:�.i
Residential improvements or Mnualy
Assessed Mobile / Manufactured Hoare
Garage
(6)
_
=� s s
L
Other improvements
(6)
MIAMI
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-,j�- ;STANDAR6DEDUCTIONAL'LOWANcE
20 _ Pay 20
Lesser of 1/2 Homestead FS vauanon or 535.000
Signature of Auditor � Date signed