HomeMy WebLinkAboutHomestead_KernCLAIM FOR HOMESTEAD PROPERTY TAX
=r CREDIT /STANDARD DEDUCTION
,` • State Form 5473 (R2 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions..
H_ n "a U.-
1�1 O FORM YEAR
HC7
cN COU. TV a1Inj 0
/ ) JwV ' `i certify that on the 1st day of March, 19
occupied as our Ocipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
°l (We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the properly 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.
r PROPERTY DESCRIPTION -
County
Township
Taxing district (city, town, township)
Parcel number
Legal description
G
Valuation or S2,000
It any portion of the residential structure or the land not exceeding one (1) arse that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
It
1
Address (number and street, city, state, ZIP code)
i
— PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County i j
Township
County
Township
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or S2,000
i
®ebyrertify the above statemenre irue„correci and complete.
S" ature ofc i an iJ
K
Address (number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or S2,000
Sfgnatu a Auditor Date signed
Otherland
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
_
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 fobs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action nature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE "
19_Pay 19_
Lesser of 112 Homestead
$
Valuation or S2,000
Sfgnatu a Auditor Date signed
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