HomeMy WebLinkAboutHomestead_HyattaL g CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
. .;� State Form 5473 (132!5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
�j FORM YEAR
11 1 HC10
.y t� AV i 1995
CERTIFICATION STATEMENT 1, Y•r„
J/DMe1/ 14eeblge6 N a� AUDITS
Y fy that on the 1st day of March, 19
a) occupie�rincipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
❑ 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.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION - -
County
Tow'nship -
A/Hu73fA.Dr
Taxing district (city, town, township) _
reby certify the above statements are true, correct and complete.
-
Address (number and sweet, dry, state. ZIP wde)
Parcel number
o /.3 00 S-00
Legal descripton
nn J
LG 302-
—
H
It 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 COUNTIES
County Township
County Township
HOMESTEAD
VALUE
Sign ture of Iaim nt ^ ,
reby certify the above statements are true, correct and complete.
(1)
Address (number and sweet, dry, state. ZIP wde)
%(
2
/ /p e(
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
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 plus line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
ying action - Signature of Auditor
Date signed
STANDARD
19 Pay 19
Lesser of 1l2 Homestead
Valuation or $2,000
S
Date signed