HomeMy WebLinkAboutHomestead_Mayer (5)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
y CREDIT /STANDARD DEDUCTIO
State Form 5473 (R2 / 5 -92) —1-6. 1
INSTRUCTIONS: See reverse side for filing instru ions. \ _ !1 Q n
w(u(_,K.QA
. . • `::CERTIFICATION STATEMENT'
I (We) _lam p n fie•. 1`-� cemfy t the y�o arch,
I (We) occupied sour . �ncipal p ace of residence the following described real property for which a Homes d Property T x- it 5 -he
by 1.
I We owned
( ) ❑ Are buying under contract
I� 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 DESCRIPTION _ -- -
County
Township
Tani
distria (dry, town, township)
Parcel number
Legal description
CZ
II 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.
(2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUE TAX
VALUE
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of imant
!ress (number and street. a4, state, ZIP code)
S
Otherland
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD .
VALUE
NON -RESIDENTIAL.
VALUE
Land not exceeding 1 (one) acre immediately
surroundingresidentialimprovements.
(1)
-
-"
Otherland
(2)
Valuation or $2,000
Signature of Auditor
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
e
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 0
(7)
Total value (line 3 plrs line 7)
(g)
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 112 Homestead
$
Valuation or $2,000
Signature of Auditor
')
Date signed -