HomeMy WebLinkAboutHomestead_Willis (8)e�• ^xm
g CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
!. State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
CERTIFICATION STATEMENT -
I (We) ertify lha n the is day of -fib _ 9_
our principal place of residence for which a Homestead Prope )"x 6fe{fit'IS hereby claimed:
"(We)
Ooccup'
o d ❑ Are buying under contract L I 'O
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns th roperty or is up i�under -a ntr t.
Legal description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that ture is used to produce income, describe the use and portion
of the property utilized to produce income. -
�'P-SON 0Ii:iTV Lr NT
state, ZlP code)
a )<
- - "CONTRACT RECORDED
It buying on contract, Fee Simple owner's name _
Recorder's office where contract is recorded
Record number
Page
- PROPERTY DESCRIPTION -
County
Township
Taxing district (city,.town, township) ,
1/ �J i
L% nl er -o/ s/ `
Legal description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that ture is used to produce income, describe the use and portion
of the property utilized to produce income. -
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
by certify the above statements are true, correct and complete.
Signature claimant A3
Address (number and street. ary,
S) &- o
state, ZlP code)
a )<
- _ —
6
/t
ASSESSOR USE ONLY
TRUE TAX'
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL..
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor
Date signed ,
- _ —
Other land
(2)
Total land (line I 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 pUs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
S
Signature of Auditor
Date signed ,
- _ —