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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
` f State Form 5473 (R8 I7 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We)
!q—
1 (We) occupied 0 our principal place of residence the following described ^re^al
w I (We) oned El Are buying under contract (/ / / j
i Have a beneficial interest in the entity that is liable for the property taxes on
OR YEAR
C10
JUN 3 0 2009
20
claimed:
is buying under a contract.
CONTRACT ••r
If drying on comracL Fee Simple owners name
Recorders office where contract is recorded Record number Page
County
Tamstup
PROPERTY ,
Taxing district ('y, to , townshl )
Parcel number
Legal descdplion
Homestead d Valuati on
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Is the property in question:
(3& -/ - /OG • oo G .
/ 9 'O
VALUE
property ❑ Mobile Home (IC 6- 1.1 -7)
"arty portion of the residential structure or the land not exceeding one (1) acre that unmedatety surrounds that stricture is used to produce Income, describe the use and portion
If tha property utilized to produce inwme.
CA4N
X(c) 31-3—lo
ASSESSOR USE ONLY
TRUE TAX VALUE
ASSESSED VALUE
HOMESTEAD
NON-RESIDENTIAL
Homestead d Valuati on
or 43,000 for 2009 pay 2010 40,000 payable after 2012
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
<� ° -;.
Other land
(2)
_
Trial land (line 1 plus roe 2)
(3)
S ,_,
Residential improvements or Annually
Dwelling
(4)
1✓''� »`,`.:< -�" _.:k
a z
Assessed Motile i Manufacttired Home
Garage
�` ��
Other improvements
(6)
f :..
• v,
Trial improvements (line 4 through One 6)
(7)
Total value (line 3 plus One 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
STANDARD DEDUCTION
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
$
Homestead d Valuati on
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor
Date signed (month, day, year)