HomeMy WebLinkAboutHomestead_Williams (21)CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
CREDMSTANDARD DEDUCTION HcTo
Slide Form 5173 CRT 1 5067
Prescrbed by Ce Depa6nent of Local Ceverrcnas Fswx:e ^I%�
INSTRUCTIONS: See reverse side for Nmg Instructions.
CERMIMMON STATFJIENT
I (We) certify that on the 1 st day of March. 20_
1 (We) occupied as our principal place of residence the following 111Treal properly for which a Homestead Properly Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
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
;i•' :('' •,. _•CONTRACT:RECORDm� w :�%'§h! t; -5313 "'l`y_ „^;, {:
If buying on .,tract, Fee Simple owrees nerve
Recorder's olfwe where corked is recorded Record number Page
"..' •. .`t.. ::;.' '. . `.''- ''” PROPERTY. OWNEDBY,Cl:AD1ANT IN "OTHER COUNTTESa ;.'....
County
: -- 'PROPERTY DESCRIPTION.. -
rS,Yn� ` tx .-
A t':- ;:;� . „ r °�,: .1.� pt:•
Comity
TaMr¢hip
(number and soaet oYy, state, ZIPcode)
Taring district (cly.
,, „
Parcel mxrbw
Lao des -ption
s ft
n question:
. _
property
Mobile Fbne (LC. 61.1 -7)
Carry portion d the residedial strw4re or the land not exceedrg one (1) acre dot ini edately surrounds that
s used to pmd ce hix rne, desube the use and portion
d the property ub5* to pmdtra irmma.
(2)
Total lard (Im 1 plus lobe 2)
(3)
"..' •. .`t.. ::;.' '. . `.''- ''” PROPERTY. OWNEDBY,Cl:AD1ANT IN "OTHER COUNTTESa ;.'....
County
Township
County
Township
I thereby certify Cho above statements are true, tarred and complete.
Signature of darrhard
(number and soaet oYy, state, ZIPcode)
w
- ASSESSOR USE ONLY r. ` n i t� '
` TRUE -:TAX "
ASSESSED VALUE
.'<a y NONDENiIAL i?yxi`
-:fi , n -
t� VALUE
' -''AT 1C0ab QF TTV
^ifO1�SiEADY�
,a.. .
,, „
Lind not exceeding 1 (one) acre irrvhediateiy
surrounding residential improvements.
Other land
(2)
Total lard (Im 1 plus lobe 2)
(3)
F, ON6g
Residential 6rprovemends or Annually
(4
Assessed Mobile I manufactured Hams
Garage
f )
Other anprovernerht5
(6)
' t y}s r
{..
.1 V_ C1
Trial bnprovmxmts (%are I though fine 6)
(n
.
TdW value (line 3 plus fine 7)
(8)
1 hereby certify the above is true,
correct, and
complete.
Sigrnffise dAsaessor
_
Date sow
STANDARD DEDUCTU
20 _ Pay 20 _
Lesser of 12 Homestead
Vd—k -- $35,000 $