HomeMy WebLinkAboutHomestead_Miller (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDMSTANDARD DEDUCTION
State Form 5473 (8715.0%
Pmambed by the Department of Local Ciovernmoni Finance
INSTRUCTIONS: See reverse side for filing instructions. P I T 1P n
7,::Pth=a�t� (1"720_
place certify
residence -ng described real property for 't, Tax $as our �Pnn,,ipd place �of residence the fo �ngdesrnbed described property �fo, -hch a �H� is hereby claimed:
((Ww:)) occu pi,
r 1 1 (We) owned ❑ Are buying under contract
7
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propQMqOsjbgjft4M#ejkajCM0gt.
ONTFtACTiRECOftDEDiO�"'N:.l4�t�—,, f
if buywig on contract. Fee surqAe owners name
Recorder's office where contract is recorded Record number Pege
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County
Township
Twdrg district (ciiy, t--, townshp)
Township
description
Signature of daimant
hi the property in question:
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;g� 'VALUEJ
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1.4"
Real Wperty ❑ Mobile H.. (LC. 61.1 -n
if arty portion of the n one (1) acre that en
su ds that strulure is used to produce income, describe the use and portion
of the property utilmd to prod" income.
106 6�
PROPERMOWNE114YCLAIMANT,
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of daimant
w(number aid sinwt oly: date. ZfPwde)
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V 'UE
AL-IM,
;g� 'VALUEJ
NIZ11.0 w
1.4"
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Land not exceeding I (one) acre immediately
00W
surrounding residential improvernents.
RN X
Other land
(2)
Tctal land (fine I plus roe 2)
(3)
Dwelling
(4)
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R k
Residential improvements a Annually
Assessed Mobile Manufticbmed Horriti
Garage
p
'p
(5)
Other improvements
(6)
Tctal improvements (fine 4 through fine 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correcL, and
complete.
Signature of Assessor
Date signed
Veffying action - Signature of Aucftx
Date signed
20 _ Pay 20_
Lesser of 12 Homestead
Valuation or 535,000