HomeMy WebLinkAboutHomestead_BurtonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Stste Form 5473 (R7 I 5-M
Presmilmd by the Depart nwd of Lmal Govenvnerd Finance
INSTRUCTIONS: See reverse side for Ming Instructions.
FORM
YEAR
I (we) _V Q� �K March, 2D_
I (We) occupied as ow principal place of a following described real property for which a Horrx4;t�F.,,.=i( of
dauned:
46MDO ,, 'y AUDITOR
0 Z1 I (We) owned ❑ Are buying under cor�tract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prop" or is buying under a contract-
?q,
it bLrj*V on mrbaY, Fee Sirnple owners name
fbxmfdees affil where cm*W m recmdod Remd number Page
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PROPE]MOESCIUIPTION,:
Canty
Thmnsh,
Township
Tacing district (cly, fD-,,. to-mdw)
Parail mxnbm
Legal desii
Ls the prop" in question:
j0pass (numbs md Zlp code)
"s—
Ran! properly ❑ Mobil. H. (LC. 61.1-7)
If a+ portion of the r (1) aae that kN arr 1 nxh that stn=ture is used to pro& inconm, describe the use and portion
011e rePedy Wind tD PM&"
Dole 8omd
surrounding residential inqxvvernents-
OWNED BYCLAWANT IN 'O*ER COUNIIES;f
r�unty
Township
County
Township
I hereby certify the above statements are true. correct and complete-
ATA
vALuE
j0pass (numbs md Zlp code)
0
77��
'-k�umomiuy
.TWE,TAX
ASSESSEDVALUE
4�l"
4tFSMENTIAU
Lesser of 12 Hornestead
ATA
vALuE
Valuation or $36.0DO
splaft" of Axotor
Land not exceeding I (one) ace ffmediately
Dole 8omd
surrounding residential inqxvvernents-
(1)
Other land
(2
Trial land (line 1 plus rve 2)
(3)
Dwe lling
(4)
Residential anprovernents or Anrxkdly
OWN
Garage
,
Assessed Mobile I Manutachmed Horne
(5)
Other improvernents
(6)
Tcted (&m 4 through line 6)
(7)
Trial value (fire 3 plus lino 7)
(8)
1 hereby car* the above is true, correct, and
SWmhxe ofAsaessor
Date signed
complete.
Vaitying action - Stnature of AuifibN
Dots Signed
--"STANDARD DEDUCTION ALLOWANCE
20_ Pay 20_
Lesser of 12 Hornestead
$
Valuation or $36.0DO
splaft" of Axotor
Dole 8omd