HomeMy WebLinkAboutHomestead_Stoll (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HCto
State Form 5473(F`12/5-92)
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INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT'" - -
1 (We) I _ I r7p tIft th t o - arch, 19
occupied as our principal place of residence the following described real property for which a Homes a Ptop�yp i ereby claimed:
lJ I (We) owned ❑ Are buying under contract („t Ay � o _,9)7y
El Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the grope y or is buying under a contract.
It buying on contract, Fee Simple owner's name
contract is recorded
Record number
I PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel number
Legal desai
tion
It any portion of the residential structure or the land not exc ing one (1) arse the i ediatety surrounds that strut ure is sed 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
#eby' ert fy the above statements are true, correct and complete. Signatur of dat nt
If
Address umberand sheet, try state, ZlP cod )
DS `hG 3
� r
- 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 1 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 ptis line 7)
(S)
1 hereby certify the above is true, Correct, and
complete.
Signature of Assessor
'
Date signed
V' "Nin9 action - Signature of Auditor
Date signed
19 _Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
of Auditor
STANDARD DEDUCTION ALLOWANCE
S