HomeMy WebLinkAboutHomestead_Hutchinson (2)a R� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (132 / 5-92) -
/1M
FORM YEAR
HC10
`.. ._ ^. - • -
.PROPERLY DESCRIPTION : • ° ° '-. - g"' ` - -
f ,. _ •. :..
-%.
County
J r,�L a
NON-RESIDENTIAL
Taxing district (dry, town. township)
CERTIMATION ,STATEMEHT'."Y'-�e.-'. -;5;) ,_fir; -. "',_ ,.`• ,rr3.:i -'
I (We) C e Otrs e fA C -L I A) S certify that on the 1st day of March, 19
rrI (We) occupied as our principal place of residence the following described real property for which a Homestead Properly Tax Credit is hereby claimed:
(We) owned 0 Are buying under contract _ -, • [gF{ y�pl� ►ry�
Have a beneficial interest in the entity that isliable for the property taxes on the property and that owns th in or. it buy D, a contract.
`
o I
P,arrcel number
- _ c.; ._•
: } �.. v . .� ?{..
CONTRACTRECORDED:...
4 '
If buying on contract Fee Simple owners name
,
.i
Recorder's office where contract is recorded
°' ° °"
'Recordnumber7D!TOR I
Page
`.. ._ ^. - • -
.PROPERLY DESCRIPTION : • ° ° '-. - g"' ` - -
f ,. _ •. :..
-%.
County
Township•
NON-RESIDENTIAL
Taxing district (dry, town. township)
hereby certify the above statements are true, correct and complete.
Signatu e of aimant
`
o I
P,arrcel number
Legal description
'
V Qto
Land not exceeding 1 (one) acre immediately
If any portion of the rewential Structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce iner me, describe the use and portion
of the property utilized to produce income.
.:,PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County -
Township
County
NON-RESIDENTIAL
Township
hereby certify the above statements are true, correct and complete.
Signatu e of aimant
`
re umber ands Gary, state, ZIPcode) - 04j a
__Q 4 -7666
' ' y -
- -
"`�.,
TRUE. -
'ASSESSED-
HOMESTEAD'
NON-RESIDENTIAL
>- 'ASSESSORUSEONLY g -
-_ VALUES., '
- VALUE;
VALUE - "-
:.
4'� VALUE F "5 -
�1. j t:
.
Land not exceeding 1 (one) acre immediately
-eo
surrounding residential improvements.
a
Otherland
(2)
Total land (line I plus line Z) ' -
(3)
'
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements -
(6)
Total improvements (line 4 through line 6)
(7) -
Total value (line 3 plis linen
(6)
-
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete. .
-
vedfying action - Signature of Auditor -
Date signed
STANDARD DEDUCTION
19 Pay 19_
Lesser of 112 Homestead
$
Valuation or $2,000
Sign re of Audii
Date signed